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South Carolina 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
$42,314.10 / $47,015.70 / $47,015.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,936.75 / $28,663.60 / $57,240.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,942.00 / $52,382.33 / $81,353.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39,651.78 / $70,240.30 / $90,691.98