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Pennsylvania rates for HCPCS 43634

Gastrectomy, partial, distal; with formation of intestinal pouch

Facilitymedian $5,370 · 10th–90th $1,000–$8,5110%10%20%10th90th$5,370Professionalmedian $2,291 · 10th–90th $1,862–$4,0740%20%40%10th90th$2,291$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $5,754.40 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $3,890.45
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,235.94 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $794.33 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,344.23 / $4,265.80
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $4,466.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,951.21 / $3,981.07
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,187.76 / $3,388.44
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $3,981.07 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $3,467.37
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,715.35 / $4,677.35
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $2,089.30
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,089.30 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $2,290.87 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,290.87 / $4,073.80