go back

Maine rates for MS-DRG 694

Urinary Stones Without Mcc

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,471.29 / $15,488.17 / $18,197.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $12,022.64 / $23,442.29
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $12,022.64 / $12,022.64