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New York rates for MS-DRG 138

Mouth procedures without CC/MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,051.49 / $15,440.30 / $26,069.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,768.07 / $23,363.72 / $30,295.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,392.27 / $22,010.35 / $32,309.97
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,326.52 / $21,764.19 / $45,640.19
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,392.27 / $23,964.00 / $32,488.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,281.00 / $20,537.68 / $30,468.44