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New Hampshire 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
$1,737.80 / $6,918.31 / $35,481.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $18,197.01 / $28,183.83
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $4,677.35 / $12,302.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $4,677.35 / $12,302.69
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,737.80 / $2,137.96