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Idaho rates for HCPCS 43774

Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $4,466.84 / $6,309.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $6,025.60 / $10,000.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,548.82 / $3,162.28
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $8,511.38 / $12,022.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $33,113.11 / $35,481.34