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Washington rates for HCPCS 43887

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

Facilitymedian $851 · 10th–90th $417–$9,7720%10%20%10th90th$851Professionalmedian $447 · 10th–90th $295–$9330%20%10th90th$447$20.0$100.0$500.0$2.0K$10.0K

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
$630.96 / $4,466.84 / $18,620.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $371.54 / $891.25
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,897.79 / $10,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $630.96 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $562.34 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $512.86 / $1,000.00
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $676.08 / $2,511.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $588.84 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $645.65 / $676.08
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $467.74 / $1,479.11
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $660.69 / $977.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,011.87 / $10,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $645.65 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $6,025.60 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $457.09 / $851.14
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $389.05 / $707.95