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Stomach To Small Bowel Bypass With Vagotomy

Utah rates for HCPCS 43825

Creates a new connection between the stomach and the jejunum, the middle part of the small intestine, so food can pass around a blocked or narrowed stomach outlet. During the same operation the nerve that drives the stomach to make acid is also cut.

Rates data updated July 2026.

Facilitymedian $3,388 · 10th–90th $1,738$6,0260%20%10th90th$3,388Professionalmedian $1,738 · 10th–90th $1,175$3,8020%10%10th90th$1,738$50.0$200.0$1.0K$5.0K

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
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$3,388.44
Typical High
$6,025.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,737.80
Typical High
$3,801.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$1,659.59
Typical High
$2,691.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,000.00
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$2,041.74
Typical High
$2,630.27
Select Health
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$2,454.71
Typical High
$2,454.71
Select Health
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$2,187.76
Typical High
$2,570.40
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,905.46
Typical High
$2,454.71
United
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$4,466.84
Typical High
$13,803.84
United
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,445.44
Typical High
$2,290.87