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Idaho rates for MS-DRG 279

Ultrasound accelerated & oth thrombolysis of periph vascular w/o MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31,736.30 / $31,736.30 / $31,736.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95,515.50 / $126,278.10 / $131,922.10
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59,178.23 / $59,505.60 / $74,047.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36,857.41 / $50,489.60 / $90,987.00