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Utah 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
$38,904.51 / $50,118.72 / $58,884.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39,810.72 / $57,543.99 / $74,131.02
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29,512.09 / $43,651.58 / $67,608.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $25,703.96 / $44,668.36