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Illinois 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
$962.40 / $1,842.00 / $5,430.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.78 / $962.40 / $1,759.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,735.66 / $12,268.80 / $24,568.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.94 / $1,384.22 / $1,997.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,016.88 / $1,578.01 / $3,787.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.54 / $1,199.65 / $1,348.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,524.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.00 / $2,800.00 / $7,384.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$881.06 / $1,243.23 / $2,127.88