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Washington rates for MS-DRG 138

Mouth Procedures Without Cc/Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $21,877.62 / $37,153.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $17,378.01 / $28,840.32
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,964.78 / $14,454.40 / $19,054.61
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,481.54 / $17,378.01 / $25,703.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $16,982.44 / $23,442.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $19,952.62 / $28,183.83