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New York rates for MS-DRG 380

Complicated Peptic Ulcer With Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,257.10 / $33,847.90 / $55,740.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37,242.90 / $55,265.89 / $71,662.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,646.00 / $44,732.27 / $71,522.19
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,078.88 / $48,189.67 / $101,055.26
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,648.00 / $47,871.44 / $71,539.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,281.00 / $32,030.95 / $61,528.71