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Wisconsin rates for MS-DRG 804

Other O.R. Procedures Of The Blood And Blood Forming Organs Without Cc/Mcc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,391.50 / $20,391.50 / $24,168.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,047.72 / $19,602.28 / $29,323.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,677.75 / $20,642.25 / $35,120.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,921.30 / $23,941.26 / $39,188.40
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.23 / $11,185.36 / $17,722.77
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,979.71 / $23,652.95 / $27,798.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,324.18 / $25,229.33 / $31,803.62