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Michigan 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
$1,227.56 / $4,112.00 / $5,756.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.72 / $5,183.77 / $7,119.79
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$997.41 / $4,112.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,296.00 / $8,514.00 / $19,256.00