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Arizona rates for HCPCS 43644

Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $6,060.00 / $15,136.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,660.00 / $6,198.03 / $10,860.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,746.00 / $16,746.00 / $22,327.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,599.95 / $2,025.83 / $9,437.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$426.04 / $792.48 / $792.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,279.00 / $10,502.00 / $23,793.00