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Washington rates for HCPCS 43763

Perq Replacement Gtube Req Revj Gstrst Trc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.61 / $1,710.00 / $18,711.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.20 / $277.82 / $576.48
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.80 / $82.80 / $82.80
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $527.08 / $946.46
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.53 / $577.44 / $2,453.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.82 / $714.97 / $947.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.70 / $295.77 / $939.54
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.02 / $271.77 / $859.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.56 / $271.50 / $832.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.77 / $493.56 / $837.20
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.00 / $635.69 / $670.00
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.68 / $299.75 / $479.27
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.41 / $355.25 / $879.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516.30 / $700.39 / $1,339.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.15 / $274.70 / $774.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.00 / $497.00 / $5,793.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.19 / $509.18 / $954.35
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.39 / $267.77 / $371.39