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Virginia rates for MS-DRG 175

Pulmonary embolism w MCC or acute cor pulmonale

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,373.30 / $23,808.60 / $27,844.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,705.82 / $23,754.60 / $32,082.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,186.54 / $19,704.00 / $29,852.45
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,706.00 / $21,127.00 / $28,712.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,274.00 / $22,204.24 / $36,517.16