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Missouri 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
$1,122.02 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $954.99 / $2,454.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,897.79 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,096.48 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,023.29 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,202.26 / $1,905.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,288.25 / $7,585.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,380.38 / $9,772.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,818.38 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,174.90 / $1,905.46