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Maine rates for HCPCS 43653

Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,301.55 / $3,301.55 / $3,301.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$657.10 / $657.10 / $1,835.00
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$65.17 / $65.17 / $65.17
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,301.55 / $3,301.55 / $3,301.55