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Virginia 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
$30,199.52 / $51,286.14 / $54,954.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33,884.42 / $50,118.72 / $70,794.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,183.83 / $40,738.03 / $61,659.50
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $37,153.52 / $54,954.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $43,651.58 / $72,443.60