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Tennessee 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
$893.00 / $2,983.00 / $9,806.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,678.00 / $3,485.00 / $5,774.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $2,269.61 / $4,371.00
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$107.75 / $107.75 / $107.75
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,793.88 / $13,044.12 / $14,630.00
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$211.41 / $1,008.48 / $1,008.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,100.00 / $11,820.00 / $22,550.00