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Wisconsin rates for MS-DRG 804

Other O.R. proc of the blood & blood forming organs w/o CC/MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $23,988.33 / $25,118.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $25,703.96 / $37,153.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,848.93 / $21,379.62 / $38,018.94
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,782.79 / $20,417.38 / $25,703.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $23,988.33 / $38,904.51
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $15,488.17 / $20,417.38
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,387.21 / $28,183.83 / $28,840.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,488.17 / $25,703.96 / $34,673.69