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Tennessee 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
$11,332.10 / $19,130.40 / $33,664.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,169.83 / $13,535.57 / $22,445.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,308.31 / $17,633.59 / $24,348.84
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29,298.40 / $29,298.40 / $34,384.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,787.00 / $16,672.02 / $23,814.07