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Michigan rates for HCPCS 43634

Gastrectomy, partial, distal; with formation of intestinal pouch

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,290.87 / $3,715.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $3,162.28 / $3,162.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $3,162.28 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,691.53 / $5,754.40
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,897.79 / $6,456.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,344.23 / $3,162.28
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,454.71 / $4,786.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $3,548.13 / $6,025.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,570.40 / $3,548.13