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Idaho rates for HCPCS 43763

Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,407.00 / $4,500.00 / $7,045.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.12 / $245.35 / $1,017.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.54 / $260.64 / $603.84
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.36 / $314.05 / $1,068.69
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.37 / $351.41 / $627.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $498.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$456.81 / $584.88 / $748.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.94 / $199.40 / $666.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.32 / $468.49 / $713.35