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Pennsylvania rates for HCPCS 43887

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

Facilitymedian $2,692 · 10th–90th $759–$8,3180%5%10%10th90th$2,692Professionalmedian $355 · 10th–90th $295–$6760%20%40%10th90th$355$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $354.81 / $660.69
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,570.40 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $346.74 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $794.33 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $371.54 / $676.08
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $501.19 / $691.83
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,621.81 / $1,949.84
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $575.44
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,995.26 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $371.54 / $954.99
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $588.84 / $741.31
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $323.59 / $1,122.02
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $346.74 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $2,630.27 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $354.81 / $616.60