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Idaho 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
$5,224.77 / $8,356.79 / $21,453.48
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,798.69 / $3,215.03 / $5,274.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,800.00 / $26,422.00 / $29,092.00