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Ohio 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
$152.57 / $2,113.00 / $9,534.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.59 / $277.82 / $424.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$711.00 / $1,750.00 / $3,943.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.34 / $227.23 / $470.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.66 / $99.19 / $122.77
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.33 / $320.10 / $378.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.19 / $265.94 / $600.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.69 / $220.14 / $543.04
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.63 / $265.94 / $581.00
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.17 / $208.00 / $531.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.45 / $332.03 / $461.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.00 / $876.00 / $3,218.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.44 / $359.50 / $640.61