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Pennsylvania rates for MS-DRG 575

Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,205.30 / $29,379.20 / $40,119.80
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,805.00 / $27,947.00 / $41,700.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,798.30 / $26,340.43 / $40,423.51
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29,610.97 / $29,610.97 / $35,956.17
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32,121.65 / $32,121.65 / $36,952.12
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,176.60 / $28,218.30 / $39,702.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,858.00 / $24,259.50 / $40,423.51
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $15,518.27 / $22,190.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,357.85 / $22,651.19 / $41,086.61