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Virginia 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
$1,198.93 / $8,294.00 / $16,589.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,525.00 / $11,065.00 / $12,418.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$610.00 / $1,727.00 / $3,218.20
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$65.17 / $65.17 / $65.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.92 / $671.92 / $959.88
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.04 / $744.59 / $1,128.36
Medcost
Facility/Professional
Facility
Modifier
80
Low / Median / High Price
$128.40 / $140.19 / $229.95
Medcost
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$89.88 / $98.14 / $160.97
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.27 / $696.03 / $1,357.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,020.00 / $12,407.00 / $26,244.00