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South Dakota rates for HCPCS 43887

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

Facilitymedian $525 · 10th–90th $309–$4,3650%20%10th90th$525Professionalmedian $355 · 10th–90th $295–$7760%20%10th90th$355$500.0$1.0K$2.0K

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
$309.03 / $2,290.87 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $331.13 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $758.58 / $954.99
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $501.19 / $891.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $501.19 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $549.54 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $512.86 / $891.25
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $794.33 / $794.33