go back

Washington 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
$22,387.21 / $33,884.42 / $56,234.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,498.45 / $26,915.35 / $44,668.36
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $22,387.21 / $30,199.52
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,848.93 / $23,442.29 / $34,673.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,197.01 / $23,442.29 / $33,113.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,471.29 / $30,199.52 / $42,657.95