go back

Alaska rates for MS-DRG 694

Urinary Stones Without Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,755.60 / $20,576.70 / $41,806.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31,452.48 / $31,452.48 / $33,417.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,415.00 / $7,415.00 / $7,415.00
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,500.00 / $12,155.44 / $19,169.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,500.00 / $12,150.77 / $33,417.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,107.00 / $10,107.00 / $10,107.00