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New Hampshire rates for MS-DRG 624

Skin grafts & wound debrid for endoc, nutrit & metab dis w/o CC/MCC

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,597.00 / $12,615.73 / $21,737.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,788.96 / $26,245.46 / $35,672.00
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,494.34 / $16,825.54 / $25,248.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,739.87 / $14,739.87 / $25,651.43