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Other Disorders of the Eye without Major Complications

Pennsylvania rates for MS-DRG 125

Other Disorders of the Eye without MCC

Rates data updated July 2026.

How much does Other Disorders of the Eye without Major Complications cost?

$11,482

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $11,482 for this service. Most negotiated rates run $8,318 to $14,454.

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 $11,482 · 10th to 90th $6,607 to $16,596
$5K$10K$20Kfacility $11,482

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
$7,079.46
Median
$11,748.98
Typical High
$16,595.87
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$14,791.08
Typical High
$25,118.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$12,302.69
Typical High
$19,498.45
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$13,489.63
Typical High
$16,595.87
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$13,182.57
Typical High
$16,595.87
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$15,488.17
Typical High
$20,892.96
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$6,918.31
Median
$11,481.54
Typical High
$16,595.87
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$6,025.60
Median
$7,585.78
Typical High
$12,302.69
United
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$10,000.00
Typical High
$17,782.79

Where Pennsylvania sits

The same service costs 7.9 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· 30th of 51

$11,482

MT $48,978NM $6,166

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.