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South Dakota rates for MS-DRG 175

Pulmonary embolism w MCC or acute cor pulmonale

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.40 / $14,454.40 / $19,498.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,135.61 / $15,488.17 / $15,488.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $12,882.50 / $23,988.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $14,125.38 / $23,442.29