| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57,166.60 | $89,144.30 | $113,589.00 | |
Medica
| Facility | $48,657.11 | $92,609.85 | $129,739.62 | |
United
| Facility | $91,273.50 | $101,024.48 | $129,739.62 |
Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolism
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57,166.60 | $89,144.30 | $113,589.00 | |
Medica
| Facility | $48,657.11 | $92,609.85 | $129,739.62 | |
United
| Facility | $91,273.50 | $101,024.48 | $129,739.62 |