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Maryland rates for HCPCS 43634

Gastrectomy, partial, distal; with formation of intestinal pouch

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,344.23 / $4,466.84
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,290.87 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $602.56 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,398.83 / $4,168.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,238.72 / $3,162.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $416.87 / $1,230.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,344.23 / $4,265.80
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,511.89 / $2,951.21