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Pennsylvania 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
$25,118.86 / $44,668.36 / $63,095.73
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,547.09 / $47,863.01 / $70,794.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,547.09 / $40,738.03 / $56,234.13
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,863.01 / $47,863.01 / $57,543.99
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,952.62 / $44,668.36 / $56,234.13
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,863.01 / $47,863.01 / $93,325.43
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,547.09 / $42,657.95 / $61,659.50
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,197.01 / $22,387.21 / $37,153.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $32,359.37 / $56,234.13