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Arizona rates for HCPCS 43772

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,671.00 / $4,474.00 / $7,960.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,295.20 / $4,835.95 / $8,473.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,746.00 / $16,746.00 / $22,327.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$883.55 / $1,130.53 / $9,943.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.00 / $6,336.00 / $28,060.00