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Utah rates for HCPCS 43887

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

Facilitymedian $3,162 · 10th–90th $1,698–$4,5710%10%20%10th90th$3,162Professionalmedian $355 · 10th–90th $295–$9120%10%20%10th90th$355$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$416.87 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $354.81 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $407.38 / $660.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,548.13 / $5,495.41
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $524.81 / $676.08
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $616.60 / $812.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $489.78 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $371.54 / $575.44