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South Dakota rates for MS-DRG 158

Dental & Oral Diseases w CC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,792.70 / $12,792.70 / $12,792.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,833.12 / $10,179.75 / $10,179.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,004.68 / $8,461.14 / $16,063.57
Sanford Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.00 / $950.00 / $950.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,004.68 / $8,461.14 / $15,537.56