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Arizona rates for HCPCS 43622

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,671.00 / $4,474.00 / $7,960.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.60 / $2,303.50 / $3,466.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,660.00 / $6,198.03 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,339.54 / $2,673.76 / $3,108.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,957.71 / $2,597.04 / $5,030.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,962.77 / $2,507.98 / $4,486.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,975.62 / $2,566.13 / $16,589.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.00 / $2,572.00 / $14,572.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,944.16 / $2,431.09 / $4,469.16