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Virginia rates for MS-DRG 904

Skin grafts for injuries w CC/MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41,109.30 / $63,665.80 / $74,457.39
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,035.82 / $65,148.34 / $91,890.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34,480.00 / $52,290.25 / $81,002.87
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,603.00 / $50,127.00 / $76,121.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,274.00 / $73,546.48 / $97,884.44