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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
$6,918.31 / $12,022.64 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,754.23 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $3,162.28 / $7,762.47
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $3,311.31 / $9,120.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $7,079.46 / $13,803.84
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $9,332.54 / $13,489.63
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $3,388.44 / $9,120.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $3,311.31 / $7,762.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $6,165.95 / $14,791.08