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Wisconsin rates for HCPCS 43774

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

Facilitymedian $7,762 · 10th–90th $1,479–$16,5960%10%10th90th$7,762Professionalmedian $2,138 · 10th–90th $1,175–$3,3880%10%20%10th90th$2,138$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,905.46 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,128.31 / $13,489.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,754.23 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,288.25 / $9,549.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,412.54 / $16,982.44
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $12,882.50 / $27,542.29
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,137.96 / $3,311.31
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $7,244.36 / $13,182.57
Quartz
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$165.96 / $724.44 / $1,318.26
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,388.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,128.31 / $16,982.44 / $22,387.21