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New Hampshire rates for HCPCS 43772

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

Facilitymedian $3,311 · 10th–90th $1,585–$38,9050%10%10th90th$3,311$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,311.31 / $11,481.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35,481.34 / $38,904.51 / $56,234.13
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $4,466.84 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $4,466.84 / $10,000.00
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $562.34 / $1,122.02