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Illinois rates for HCPCS 43622

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

Facilitymedian $4,467 · 10th–90th $1,148–$9,7720%10%10th90th$4,467Professionalmedian $2,692 · 10th–90th $2,138–$5,2480%20%10th90th$2,692$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $4,466.84 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,511.89 / $4,677.35
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $27,542.29 / $52,480.75
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,388.44 / $4,265.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,090.30 / $5,128.61
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $4,168.69 / $12,882.50
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,019.95 / $3,388.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $2,818.38 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,884.03 / $4,897.79