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West Virginia rates for HCPCS 43622

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,400.00 / $2,384.59 / $3,630.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,996.76 / $2,384.59 / $2,846.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,455.17 / $2,811.31 / $3,062.97
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,397.00 / $2,722.64 / $2,722.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,631.54 / $2,631.54 / $2,631.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,997.55 / $3,151.24 / $6,641.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,815.10 / $2,450.38 / $3,630.19