go back

Illinois rates for HCPCS 43763

Perq Replacement Gtube Req Revj Gstrst Trc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.45 / $1,289.00 / $5,389.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.25 / $277.81 / $460.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.69 / $471.56 / $1,762.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.98 / $305.33 / $540.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.19 / $400.00 / $908.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.74 / $262.36 / $586.08
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.90 / $450.45 / $1,764.91
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.01 / $111.61 / $428.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $484.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.00 / $891.00 / $3,399.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.57 / $422.86 / $698.63