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Montana rates for HCPCS 43843

Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.82 / $1,254.75 / $6,617.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,029.06 / $2,029.06 / $2,029.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,184.97 / $2,029.06 / $3,631.41
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,251.20 / $1,679.37 / $2,299.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,266.73 / $2,070.53 / $3,450.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,758.73 / $2,125.44 / $2,700.94