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Upper Limb and Toe Amputation, Circulatory (with MCC)

Pennsylvania rates for MS-DRG 255

Upper Limb and Toe Amputation for Circulatory System Disorders with MCC

Rates data updated July 2026.

How much does Upper Limb and Toe Amputation, Circulatory (with MCC) cost?

$40,738

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $40,738 for this service. Most negotiated rates run $29,512 to $51,286.

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 $40,738 · 10th to 90th $22,909 to $58,884
$10K$20K$50Kfacility $40,738

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
$24,547.09
Median
$42,657.95
Typical High
$58,884.37
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$24,547.09
Median
$47,863.01
Typical High
$72,443.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$23,442.29
Median
$41,686.94
Typical High
$56,234.13
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$47,863.01
Median
$47,863.01
Typical High
$57,543.99
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$23,988.33
Median
$44,668.36
Typical High
$54,954.09
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$47,863.01
Median
$47,863.01
Typical High
$109,647.82
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$24,547.09
Median
$40,738.03
Typical High
$58,884.37
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$23,988.33
Typical High
$40,738.03
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$34,673.69
Typical High
$63,095.73

Where Pennsylvania sits

The same service costs 3.5 times more in Montana 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· 27th of 51

$40,738

MT $75,858MI $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.