go back

Missouri rates for HCPCS 43887

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,110.00 / $2,782.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.62 / $348.64 / $499.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.00 / $4,050.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.57 / $380.14 / $615.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,652.00 / $1,652.00 / $1,652.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.27 / $430.97 / $715.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.62 / $501.69 / $1,509.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.82 / $557.16 / $2,442.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.00 / $2,332.00 / $3,041.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.20 / $443.10 / $771.94