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Pennsylvania 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
$76.34 / $988.00 / $5,750.00
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$19.28 / $19.28 / $126.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.07 / $191.19 / $294.52
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.32 / $32.32 / $32.32
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,083.51 / $1,395.00 / $12,759.45
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.84 / $218.64 / $370.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.41 / $371.79 / $1,113.00
Cigna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$51.42 / $51.42 / $51.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.65 / $210.41 / $401.36
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.74 / $82.74 / $82.74
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.11 / $345.53 / $438.04
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$350.80 / $660.53 / $1,152.90
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $38.65 / $259.12
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.40 / $1,293.93 / $6,432.00
Martin's Point
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$19.28 / $19.28 / $126.89
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.68 / $205.30 / $463.35
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.30 / $275.30 / $275.30
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $275.30 / $643.40
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.27 / $491.00 / $1,404.00
Priority Health
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$51.42 / $51.42 / $51.42
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.65 / $211.02 / $405.98
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.06 / $42.77 / $236.47
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.06 / $214.55 / $237.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.00 / $512.00 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.53 / $252.91 / $430.16