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New Hampshire rates for MS-DRG 124

Other Disorders Of The Eye With Mcc Or Thrombolytic Agent

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,610.45 / $15,893.60 / $28,255.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,686.93 / $23,886.00 / $28,883.00
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,340.47 / $19,128.06 / $28,101.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,578.18 / $15,578.18 / $27,110.32