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Tennessee rates for MS-DRG 904

Skin grafts for injuries w CC/MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30,696.10 / $51,820.10 / $91,188.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,729.64 / $27,882.41 / $45,401.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,922.91 / $46,973.55 / $64,451.89
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102,319.15 / $102,319.15 / $120,080.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,787.00 / $45,160.76 / $64,506.98