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Indiana rates for HCPCS 43763

Perq Replacement Gtube Req Revj Gstrst Trc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.23 / $346.67 / $5,634.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.86 / $272.54 / $415.24
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.80 / $82.80 / $82.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$600.00 / $4,119.97 / $8,230.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.67 / $181.69 / $374.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.04 / $101.45 / $407.21
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.89 / $332.22 / $433.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.19 / $175.16 / $761.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.72 / $185.33 / $497.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $2,174.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.31 / $371.66 / $628.62