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South Dakota 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
$25,267.60 / $25,267.60 / $25,267.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,421.98 / $20,106.63 / $20,106.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,860.20 / $16,712.09 / $32,599.38
Sanford Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $1,450.00 / $1,450.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,860.20 / $16,712.09 / $30,689.17