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Texas rates for MS-DRG 175

Pulmonary embolism w MCC or acute cor pulmonale

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,804.00 / $20,295.00 / $31,139.50
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,257.94 / $18,251.89 / $21,905.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.00 / $3,027.00 / $21,105.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,793.73 / $19,368.00 / $33,210.90
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,772.90 / $43,823.01 / $43,823.01
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37,753.55 / $45,939.40 / $59,702.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,128.89 / $17,170.00 / $33,210.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,257.00 / $15,384.32 / $35,172.40