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North Carolina rates for MS-DRG 694

Urinary Stones Without Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$789.00 / $4,479.00 / $11,502.70
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,684.99 / $17,684.99 / $17,684.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.36 / $9,248.29 / $14,338.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,584.05 / $11,505.00 / $15,464.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,248.50 / $12,124.95 / $18,011.00