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Missouri rates for HCPCS 43622

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

Facilitymedian $4,266 · 10th–90th $2,089–$8,5110%5%10%10th90th$4,266Professionalmedian $2,570 · 10th–90th $2,089–$4,6770%10%20%10th90th$2,570$100.0$500.0$2.0K$10.0K

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
$2,137.96 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,511.89 / $4,677.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,677.35 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,630.27 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,691.53 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,818.38 / $4,786.30
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,884.03 / $6,456.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,388.44 / $16,595.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,818.38 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,818.38 / $4,677.35