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Utah 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
$19,498.45 / $25,118.86 / $30,902.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,952.62 / $24,547.09 / $33,113.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,848.93 / $20,892.96 / $37,153.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $19,498.45 / $22,387.21