go back

South Dakota rates for MS-DRG 173

Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary Embolism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41,851.19 / $41,851.19 / $41,851.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32,168.93 / $33,302.94 / $33,302.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,644.24 / $27,680.52 / $52,405.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,644.24 / $27,680.52 / $50,830.96