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Washington rates for MS-DRG 158

Dental & Oral Diseases w CC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,129.20 / $22,535.70 / $39,685.50
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,874.56 / $19,687.84 / $28,620.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,064.73 / $17,522.75 / $29,354.70
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,180.82 / $14,853.30 / $18,264.28
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,409.00 / $17,520.57 / $26,784.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,534.11 / $18,957.70 / $25,774.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,775.00 / $14,115.55 / $36,771.39