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Alaska rates for MS-DRG 804

Other O.R. proc of the blood & blood forming organs w/o CC/MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,118.86 / $37,153.52 / $77,624.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54,954.09 / $54,954.09 / $57,543.99
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,703.96 / $25,703.96 / $25,703.96
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $20,892.96 / $26,915.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54,954.09 / $54,954.09 / $57,543.99