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California rates for MS-DRG 175

Pulmonary embolism w MCC or acute cor pulmonale

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,557.40 / $26,173.90 / $42,442.50
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,526.71 / $19,526.71 / $19,526.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,231.39 / $23,516.46 / $54,134.80
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $20,833.08 / $38,226.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,911.53 / $27,472.00 / $48,191.38
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,716.08 / $37,341.15 / $43,823.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,709.75 / $23,344.33 / $48,611.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,693.00 / $21,270.20 / $43,545.87