go back

Montana 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
$2,809.75 / $2,809.75 / $13,476.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,519.56 / $1,519.56 / $1,519.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.44 / $1,335.23 / $1,734.95