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Vermont rates for MS-DRG 138

Mouth procedures without CC/MCC

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,993.68 / $18,900.87 / $25,043.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,631.74 / $14,018.80 / $24,490.14
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,631.74 / $14,018.80 / $24,490.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31,406.04 / $31,406.04 / $31,406.04