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North Carolina rates for MS-DRG 175

Pulmonary embolism w MCC or acute cor pulmonale

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$789.00 / $5,100.00 / $20,212.50
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,794.14 / $20,283.41 / $24,787.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.36 / $15,965.35 / $24,319.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,326.67 / $20,095.77 / $26,852.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,494.23 / $21,959.74 / $32,216.41