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Pennsylvania rates for MS-DRG 905

Skin Grafts For Injuries Without Cc/Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,577.60 / $24,252.10 / $33,118.40
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,219.00 / $24,938.83 / $38,646.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,847.73 / $22,740.52 / $33,369.08
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,443.47 / $24,443.47 / $29,681.35
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40,044.08 / $44,370.91 / $47,702.99
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,377.30 / $23,734.40 / $33,118.40
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,086.14 / $20,055.57 / $33,369.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $12,913.80 / $18,317.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,899.29 / $18,698.25 / $33,916.46