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Utah 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
$25,211.90 / $32,504.50 / $40,868.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,557.16 / $43,936.83 / $56,862.02
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,078.82 / $26,987.40 / $40,455.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,775.00 / $3,775.00 / $17,193.70