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Massachusetts rates for HCPCS 43622

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

Facilitymedian $3,090 · 10th–90th $1,445–$5,6230%10%10th90th$3,090Professionalmedian $2,754 · 10th–90th $2,188–$6,0260%10%10th90th$2,754$100.0$500.0$2.0K$10.0K$50.0K

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
$2,187.76 / $3,388.44 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,454.71 / $5,754.40
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $2,511.89 / $14,125.38
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,235.94 / $16,218.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $741.31 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $3,090.30 / $6,309.57
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,884.03 / $4,466.84
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,754.23 / $4,073.80
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $2,511.89 / $4,677.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,801.89 / $5,623.41
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $2,511.89 / $14,125.38
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,235.94 / $16,218.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $2,511.89 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,548.13 / $6,606.93