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Michigan rates for MS-DRG 173

Ultrasound accelerated & oth thrombolysis w PDX pulmonary embolism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,858.40 / $26,043.50 / $42,276.80
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,919.09 / $47,919.09 / $47,919.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35,037.82 / $49,811.49 / $63,860.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,969.96 / $40,543.44 / $48,571.87
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,632.30 / $28,007.90 / $44,785.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,790.22 / $37,261.55 / $56,611.13