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Missouri rates for MS-DRG 904

Skin grafts for injuries w CC/MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,034.00 / $42,843.00 / $71,129.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,853.95 / $40,228.80 / $68,148.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36,929.35 / $46,832.03 / $69,154.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,079.00 / $43,897.22 / $120,080.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,079.00 / $43,801.72 / $61,561.16