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Pennsylvania rates for MS-DRG 256

Upper limb and toe amputation for circulatory system disorders with CC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,021.40 / $27,759.00 / $37,907.30
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,722.00 / $29,375.46 / $42,355.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,860.02 / $25,704.51 / $37,774.87
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,978.00 / $27,978.00 / $33,973.28
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,579.38 / $18,213.68 / $29,119.97
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,311.70 / $27,759.00 / $37,907.30
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,982.21 / $22,955.61 / $35,703.19
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $13,253.93 / $18,823.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,896.93 / $21,402.03 / $38,820.79