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West Virginia 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
$975.78 / $1,400.00 / $1,700.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.10 / $1,154.28 / $1,257.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,083.76 / $1,083.76 / $1,083.76