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Virginia 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
$101.14 / $3,226.00 / $8,294.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.49 / $277.82 / $418.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,735.00 / $2,390.00 / $2,954.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.95 / $242.26 / $487.47
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.18 / $92.16 / $179.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.35 / $172.55 / $610.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.83 / $246.02 / $584.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.49 / $384.36 / $551.45
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.37 / $329.26 / $587.04
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.27 / $507.00 / $623.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.93 / $112.38 / $202.02
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.36 / $436.37 / $800.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $503.00 / $2,117.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.94 / $391.12 / $638.19