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New Hampshire rates for MS-DRG 694

Urinary Stones Without Mcc

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $12,589.25 / $19,054.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $16,218.10 / $28,840.32
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $14,125.38 / $14,791.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $9,120.11 / $16,595.87