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Wisconsin rates for MS-DRG 158

Dental & Oral Diseases w CC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,681.60 / $13,681.60 / $16,215.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,249.70 / $16,676.83 / $24,947.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,189.84 / $13,849.79 / $23,563.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,011.36 / $16,063.25 / $26,293.22
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.78 / $9,516.04 / $13,596.15
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,392.43 / $15,869.81 / $18,651.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,281.67 / $16,927.47 / $21,338.45