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Florida rates for HCPCS 43622

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,500.00 / $4,790.00 / $11,576.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,929.06 / $2,300.54 / $3,399.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $500.00 / $7,117.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,908.67 / $2,965.21 / $4,584.16
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,624.00 / $21,162.00 / $32,051.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,063.89 / $1,856.00 / $2,833.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.22 / $2,169.18 / $3,252.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$573.00 / $4,414.00 / $9,150.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.65 / $2,462.32 / $4,575.10
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,771.70 / $1,771.70 / $1,771.70