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Montana 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
$6,760.83 / $15,848.93 / $46,773.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $81,283.05 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $2,754.23 / $2,754.23
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,951.21 / $3,311.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,398.83 / $4,168.69