go back

Wisconsin 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
$44,759.10 / $44,759.10 / $53,048.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36,607.43 / $45,309.44 / $77,088.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32,752.04 / $52,550.72 / $86,017.96
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.90 / $31,045.03 / $44,355.88
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37,270.21 / $51,917.88 / $61,016.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33,636.36 / $55,378.01 / $69,808.49