go back

Pennsylvania 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
$1,071.52 / $6,165.95 / $10,964.78
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $10,000.00 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,621.81 / $7,943.28
Cigna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$97.72 / $97.72 / $97.72
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,332.54 / $16,595.87 / $47,863.01
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $5,370.32 / $10,964.78
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $691.83 / $1,174.90
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $5,011.87 / $17,782.79