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Pennsylvania rates for MS-DRG 113

Amput For Circ Disor Exc Uppr Limb & Toe

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,185.00 / $38,438.10 / $52,490.70
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,385.00 / $36,349.65 / $51,995.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,361.31 / $34,462.42 / $49,561.19
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38,741.43 / $38,741.43 / $47,043.16
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30,285.07 / $47,543.57 / $50,703.40
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,202.20 / $37,617.60 / $51,945.20
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,958.27 / $31,474.18 / $49,018.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $17,471.99 / $25,080.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,744.53 / $29,635.62 / $53,755.55