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Nebraska rates for HCPCS 43622

Gstrct Tot W/Frmj Intstinal Pouch Any Type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,241.22 / $10,431.19 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,027.20 / $2,027.20 / $3,782.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,856.25 / $22,987.11 / $40,340.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,952.81 / $3,328.67 / $4,438.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,803.16 / $5,038.81 / $7,183.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,027.20 / $3,425.97 / $4,876.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,186.99 / $4,774.10 / $16,589.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,606.00 / $5,050.17 / $6,755.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,300.00 / $5,050.17 / $6,755.19
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $2,933.60 / $5,932.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,054.00 / $4,317.00 / $13,909.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,186.99 / $4,670.53 / $5,949.05