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Indiana 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
$19,054.61 / $26,302.68 / $29,512.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,803.84 / $24,547.09 / $32,359.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $19,054.61 / $46,773.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $18,620.87 / $27,542.29