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Utah 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
$144.54 / $2,754.23 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $199.53 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $239.88 / $416.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $87.10
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $512.86 / $912.01
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $83.18 / $407.38
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $251.19 / $436.52
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $281.84 / $446.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $181.97 / $331.13