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Montana rates for HCPCS 43762

Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $204.17 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $125.89 / $446.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $81,283.05 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $58.88 / $354.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $58.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $213.80 / $489.78
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $354.81 / $416.87
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $354.81 / $416.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $199.53 / $489.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $97.72 / $575.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $144.54 / $416.87