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Utah rates for MS-DRG 257

Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,323.60 / $19,755.90 / $30,408.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,141.20 / $22,097.71 / $26,704.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,968.95 / $13,637.50 / $18,070.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,775.00 / $3,775.00 / $10,450.17