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Idaho rates for MS-DRG 575

Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,813.60 / $15,813.60 / $15,813.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,593.55 / $62,921.96 / $65,734.25
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30,941.21 / $36,032.76 / $36,896.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,764.00 / $25,824.61 / $42,773.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,365.34 / $23,361.00 / $33,814.15