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Pennsylvania rates for MS-DRG 004

Tracheostomy with Mechanical Ventilation >96 Hours or Principal Diagnosis Except Face, Mouth and Neck without Major O.R. Procedures

Rates data updated July 2026.

How much does MS-DRG 004 cost?

$204,174

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $204,174 for this service. Most negotiated rates run $141,254 to $257,040.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $204,174 · 10th to 90th $114,815 to $288,403
$10K$20K$50K$100K$200Kfacility $204,174

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$125,892.54
Median
$208,929.61
Typical High
$288,403.15
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$213,796.21
Typical High
$371,535.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104,712.85
Median
$208,929.61
Typical High
$295,120.92
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$245,470.89
Median
$245,470.89
Typical High
$295,120.92
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$123,026.88
Median
$223,872.11
Typical High
$275,422.87
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$158,489.32
Median
$234,422.88
Typical High
$575,439.94
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$125,892.54
Median
$204,173.79
Typical High
$295,120.92
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$104,712.85
Median
$125,892.54
Typical High
$213,796.21
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$177,827.94
Typical High
$323,593.66

Where Pennsylvania sits

The same service costs 17.8 times more in New York than in Michigan. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 25th of 51

$204,174

NY $380,189MI $21,380

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.