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Montana rates for HCPCS 43848

Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,019.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,311.31 / $3,715.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,630.27 / $4,677.35