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Texas 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
$4,804.00 / $37,682.00 / $61,150.10
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33,734.56 / $33,734.56 / $33,734.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.00 / $3,027.00 / $38,058.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,276.60 / $37,577.48 / $71,103.46
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48,537.00 / $69,337.25 / $81,373.14
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,074.30 / $33,717.50 / $77,768.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,257.00 / $30,210.88 / $69,069.62