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Montana rates for HCPCS 43772

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

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,502.21 / $1,502.21 / $1,502.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$927.50 / $1,327.92 / $1,729.89