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Alabama rates for MS-DRG 255

Upper limb and toe amputation for circulatory system disorders with MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,587.00 / $21,322.90 / $24,584.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,252.00 / $3,485.00 / $5,462.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,644.92 / $24,902.40 / $42,740.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,137.00 / $24,233.44 / $37,631.43