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Utah rates for HCPCS 43886

Gastric restrictive procedure, open; revision of subcutaneous port component only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $389.05 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $457.09 / $758.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,888.44 / $6,918.31 / $13,803.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $588.84 / $741.31
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $676.08 / $912.01
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $549.54 / $741.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $398.11 / $630.96