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Indiana rates for MS-DRG 694

Urinary Stones Without Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,779.12 / $14,563.10 / $19,542.50
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,638.63 / $10,638.63 / $10,638.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,966.18 / $12,343.77 / $19,521.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,208.84 / $11,725.50 / $26,891.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,153.70 / $11,346.38 / $16,225.75