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Pennsylvania rates for MS-DRG 384

Uncomplicated peptic ulcer without MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,065.89 / $13,975.10 / $19,084.30
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,534.00 / $15,117.00 / $23,775.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,481.21 / $13,334.88 / $19,017.59
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,085.39 / $14,085.39 / $17,103.68
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,531.96 / $16,206.52 / $19,064.75
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,708.59 / $13,791.00 / $19,084.30
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,039.28 / $12,505.72 / $18,331.16
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $7,024.21 / $9,665.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,130.00 / $10,774.75 / $19,544.15