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Massachusetts rates for HCPCS 43771

Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $3,311.31 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,380.38 / $3,388.44
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $4,466.84 / $17,378.01
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,819.70 / $9,772.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $676.08 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,698.24 / $3,548.13
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $1,995.26 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,737.80 / $2,511.89
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $4,570.88 / $27,542.29
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,187.76 / $3,311.31
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $4,466.84 / $17,378.01
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,819.70 / $9,772.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $4,265.80 / $21,379.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,778.28 / $3,630.78