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Wisconsin rates for MS-DRG 175

Pulmonary embolism w MCC or acute cor pulmonale

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,656.20 / $20,656.20 / $24,481.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,354.96 / $24,983.34 / $37,373.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,894.22 / $20,910.18 / $35,576.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,114.97 / $24,252.01 / $39,697.04
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.88 / $14,255.86 / $20,368.20
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,200.09 / $23,959.95 / $28,158.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,523.08 / $25,556.79 / $32,216.41