go back

Pennsylvania rates for MS-DRG 257

Upper limb & toe amputation for circ system disorders w/o CC/MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,306.00 / $17,856.40 / $24,384.50
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,480.00 / $19,206.93 / $29,127.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,558.93 / $17,038.32 / $25,432.00
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,997.27 / $17,997.27 / $21,853.83
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,849.45 / $17,856.40 / $24,384.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,994.27 / $14,766.54 / $23,864.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $7,192.18 / $9,913.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,404.00 / $13,767.18 / $24,972.06