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Idaho rates for HCPCS 64755

Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,148.15 / $2,187.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,467.37 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,698.24 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,258.93 / $1,584.89
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,445.44 / $2,454.71
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,621.81 / $2,187.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,778.28 / $1,949.84
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $812.83 / $1,949.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $3,715.35 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,380.38 / $1,862.09