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Michigan 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
$1,244.17 / $4,933.00 / $14,180.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,726.44 / $6,799.45 / $9,338.87
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,003.30 / $4,112.00 / $9,177.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,356.00 / $12,127.00 / $19,256.00