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Tennessee rates for MS-DRG 173

Ultrasound accelerated & oth thrombolysis w PDX pulmonary embolism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,873.80 / $41,991.10 / $73,892.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,109.20 / $40,411.65 / $65,814.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,626.59 / $38,705.49 / $52,226.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,520.00 / $37,077.01 / $52,271.54