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Nebraska 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
$5,463.36 / $11,995.87 / $34,437.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,219.04 / $16,264.47 / $28,543.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,530.28 / $2,601.48 / $4,367.38
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$792.48 / $792.48 / $792.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,762.00 / $3,810.02 / $5,401.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,939.00 / $8,158.00 / $9,496.00