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South Carolina rates for HCPCS 43622

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

Facilitymedian $3,388 · 10th–90th $2,291–$9,1200%10%10th90th$3,388Professionalmedian $2,512 · 10th–90th $2,042–$3,7150%20%10th90th$2,512$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
$2,691.53 / $7,943.28 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,511.89 / $3,467.37
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,187.76 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $562.34 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,754.23 / $5,495.41
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,691.53 / $3,235.94
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,884.03 / $4,677.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $5,888.44 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,511.89 / $4,265.80