go back

Idaho rates for MS-DRG 173

Ultrasound accelerated & oth thrombolysis w PDX pulmonary embolism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,192.30 / $26,192.30 / $26,192.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78,829.95 / $104,218.65 / $108,876.71
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49,110.60 / $49,381.70 / $61,112.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30,418.81 / $38,693.19 / $56,006.92