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Indiana 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
$1,995.26 / $4,677.35 / $19,054.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,471.29 / $24,547.09 / $31,622.78
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,698.24 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $2,951.21 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$3,548.13 / $3,548.13 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$295.12 / $295.12 / $295.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $11,220.18 / $17,378.01