go back

Alaska rates for MS-DRG 175

Pulmonary embolism w MCC or acute cor pulmonale

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,899.59 / $36,157.30 / $73,461.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,268.17 / $55,268.17 / $58,721.40
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,500.00 / $21,359.48 / $34,568.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,500.00 / $21,911.51 / $58,721.40