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Tennessee rates for MS-DRG 694

Urinary Stones Without Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,532.67 / $11,028.20 / $19,406.50
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,612.54 / $10,612.54 / $13,553.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,271.08 / $7,782.86 / $12,673.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,942.48 / $10,165.33 / $14,633.42
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,707.09 / $20,707.09 / $24,301.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,158.00 / $10,134.74 / $16,462.59