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Michigan rates for MS-DRG 694

Urinary Stones Without Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,893.43 / $7,191.64 / $11,103.30
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,848.48 / $9,848.48 / $11,512.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,211.04 / $11,673.24 / $14,965.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,507.40 / $10,648.04 / $13,467.84
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,893.43 / $7,355.80 / $11,762.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,722.83 / $9,345.21 / $14,696.74