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Wisconsin rates for HCPCS 43641

Vgtmy W/Pyloroplasty W/Wo Gastrost Parietal Cell

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,270.66 / $2,369.27 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,080.91 / $1,270.66 / $3,418.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,979.00 / $13,297.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,126.27 / $2,606.48 / $6,712.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,967.39 / $3,467.63 / $5,319.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,321.76 / $3,966.00 / $4,732.66
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,151.24 / $1,464.15 / $2,490.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,131.25 / $1,632.34 / $4,821.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,234.30 / $2,741.17 / $8,760.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.40 / $817.96 / $2,519.03
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,151.24 / $1,443.70 / $2,490.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,185.80 / $2,915.13 / $4,787.80
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,373.52 / $11,130.08 / $11,130.08
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,036.18 / $5,649.40 / $8,760.76
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,232.55 / $4,232.55 / $4,232.55
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,827.69 / $5,778.59 / $5,778.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $6,032.00 / $19,003.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,221.46 / $2,411.34 / $5,098.58