go back

Maine 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 / $2,398.83 / $4,265.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $13,489.63 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $3,090.30 / $5,011.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $2,754.23 / $4,897.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,548.13 / $6,165.95
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,884.03 / $6,606.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,951.21 / $4,677.35