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Utah rates for HCPCS 43763

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

Facilitymedian $3,020 · 10th–90th $347–$4,5710%10%10th90th$3,020Professionalmedian $295 · 10th–90th $79–$5620%10%10th90th$295$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $295.12 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $257.04 / $588.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $199.53
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $478.63 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $186.21 / $602.56
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $354.81 / $630.96
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $416.87 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $251.19 / $512.86