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Alaska rates for HCPCS 43622

Gastrectomy, total; with formation of intestinal pouch, any type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,668.62 / $10,900.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,273.62 / $2,513.53 / $12,191.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,228.21 / $3,469.77 / $7,789.83
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,304.91 / $12,191.54 / $17,068.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,611.30 / $8,422.59 / $15,558.57
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,122.48 / $10,804.80 / $17,121.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,304.91 / $12,191.54 / $17,068.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,719.12 / $8,254.79 / $14,941.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,097.50 / $6,231.86 / $17,189.59