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Louisiana rates for MS-DRG 173

Ultrasound accelerated & oth thrombolysis w PDX pulmonary embolism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,751.30 / $25,873.80 / $43,303.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,272.00 / $30,819.01 / $46,596.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,191.83 / $29,109.19 / $48,815.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,350.00 / $29,683.64 / $52,238.80