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Maine rates for MS-DRG 804

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

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $26,915.35 / $31,622.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,782.79 / $20,892.96 / $40,738.03
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,379.62 / $21,379.62 / $21,379.62