go back

Pennsylvania rates for HCPCS 43633

Gastrectomy, partial, distal; with Roux-en-Y reconstruction

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $4,264.00 / $9,534.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $800.00 / $2,193.30
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,306.81 / $4,306.81 / $4,306.81
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,092.57 / $5,092.57 / $5,092.57
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $4,761.00 / $8,451.00
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,415.30 / $1,415.30 / $1,415.30
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $800.00 / $2,193.30
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,754.37 / $1,878.88 / $1,878.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.00 / $2,215.00 / $6,612.00