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Idaho rates for HCPCS 43634

Gastrectomy, partial, distal; with formation of intestinal pouch

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $5,519.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,075.01 / $2,857.24 / $6,083.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,686.85 / $3,246.90 / $3,969.65
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,954.59 / $3,657.27 / $6,448.75
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,408.32 / $3,614.89 / $4,131.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $2,867.10 / $3,606.99
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,601.40 / $4,213.18 / $4,284.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,700.00 / $15,298.00 / $26,104.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,943.78 / $2,918.22 / $4,594.64