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Tennessee 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
$1,379.00 / $2,800.00 / $10,234.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,678.00 / $3,549.00 / $5,737.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $525.00 / $4,371.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,666.20 / $12,896.40 / $14,630.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,236.00 / $5,594.00 / $18,353.00