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Washington rates for HCPCS 43634

Gastrectomy, partial, distal; with formation of intestinal pouch

Facilitymedian $4,169 · 10th–90th $2,291–$10,2330%10%10th90th$4,169Professionalmedian $2,754 · 10th–90th $1,862–$5,2480%10%10th90th$2,754$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
$3,890.45 / $5,248.07 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,398.83 / $5,128.61
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,073.80 / $5,370.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $870.96 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,235.94 / $6,165.95
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,467.37 / $5,248.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,311.31 / $5,248.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $933.25
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $4,073.80 / $4,168.69
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,168.69 / $6,025.60
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,073.80 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,258.93 / $3,715.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,951.21 / $5,495.41
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $3,890.45