go back

Maine 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
$6,918.31 / $18,197.01 / $41,686.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $22,387.21 / $29,512.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $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
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $24,547.09 / $47,863.01