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Pennsylvania rates for MS-DRG 216

Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89,542.00 / $159,939.00 / $220,480.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,946.00 / $179,649.90 / $237,476.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85,619.07 / $143,396.28 / $217,044.00
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161,200.98 / $161,200.98 / $195,744.05
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101,694.07 / $173,905.99 / $279,143.61
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88,064.80 / $159,939.00 / $218,452.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80,561.36 / $132,263.46 / $203,961.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $73,278.48 / $107,259.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45,499.80 / $120,974.10 / $223,673.94