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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
$6,025.60 / $8,511.38 / $34,673.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $14,791.08 / $28,840.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $2,570.40 / $8,128.31
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$794.33 / $794.33 / $794.33
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $3,890.45 / $5,370.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $7,244.36 / $10,000.00