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Montana rates for MS-DRG 255

Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,550.00 / $41,000.00 / $47,500.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62,800.87 / $62,800.87 / $62,800.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,885.12 / $23,885.12 / $62,800.87