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Concussion with Major Complications

Pennsylvania rates for MS-DRG 088

Concussion with MCC

Rates data updated July 2026.

How much does Concussion with Major Complications cost?

$20,417

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $20,417 for this service. Most negotiated rates run $14,454 to $27,542.

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 8 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $20,417 · 10th to 90th $11,482 to $33,113
$5K$10K$20Kfacility $20,417

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
$12,302.69
Median
$22,387.21
Typical High
$33,884.42
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$18,620.87
Median
$29,512.09
Typical High
$43,651.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$21,877.62
Typical High
$30,199.52
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$23,988.33
Median
$23,988.33
Typical High
$28,840.32
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$22,908.68
Typical High
$28,183.83
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$12,302.69
Median
$20,417.38
Typical High
$31,622.78
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$13,182.57
Typical High
$21,877.62
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$17,782.79
Typical High
$31,622.78

Where Pennsylvania sits

The same service costs 6.6 times more in Montana than in New Mexico. 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· 28th of 51

$20,417

MT $72,444NM $10,965

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.