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Arizona rates for MS-DRG 175

Pulmonary embolism w MCC or acute cor pulmonale

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,240.10 / $22,255.10 / $29,250.80
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,937.06 / $12,937.06 / $18,550.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,958.84 / $21,674.92 / $36,660.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,481.85 / $22,353.97 / $37,415.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,169.96 / $24,947.32 / $36,425.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,169.96 / $23,191.86 / $36,425.12