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Nebraska rates for MS-DRG 115

Extraocular Procedures Except Orbit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,782.79 / $25,118.86 / $32,359.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,182.57 / $21,877.62 / $30,199.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,803.84 / $26,302.68 / $36,307.81
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,182.57 / $24,547.09 / $30,199.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $26,302.68 / $36,307.81