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North Carolina rates for HCPCS 43622

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,615.00 / $2,273.62 / $6,953.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,166.62 / $2,300.54 / $3,492.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,353.84 / $4,164.05 / $5,763.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $518.28 / $35,600.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,129.98 / $3,298.92 / $5,895.45
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,196.23 / $2,728.34 / $4,202.22
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,004.99 / $2,917.00 / $6,030.65
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,731.30 / $2,060.50 / $4,837.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$301.00 / $661.00 / $4,877.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.70 / $2,634.14 / $5,677.85
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $17,182.48 / $20,701.04
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,210.16 / $16,210.16 / $19,860.00