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Appendix Procedures with Major Complications

Pennsylvania rates for MS-DRG 397

Appendix Procedures with MCC

Rates data updated July 2026.

How much does Appendix Procedures with Major Complications cost?

$38,019

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $38,019 for this service. Most negotiated rates run $29,512 to $47,863.

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 $38,019 · 10th to 90th $21,878 to $57,544
$10K$20K$50Kfacility $38,019

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
$21,877.62
Median
$36,307.81
Typical High
$57,543.99
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$21,877.62
Median
$43,651.58
Typical High
$63,095.73
Cigna
Setting
Facility
Modifier
Global
Typical Low
$20,892.96
Median
$38,904.51
Typical High
$52,480.75
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$42,657.95
Median
$42,657.95
Typical High
$51,286.14
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$39,810.72
Typical High
$48,977.88
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$23,442.29
Median
$33,113.11
Typical High
$50,118.72
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$35,481.34
Typical High
$56,234.13
United
Setting
Facility
Modifier
Global
Typical Low
$10,964.78
Median
$32,359.37
Typical High
$56,234.13

Where Pennsylvania sits

The same service costs 3.2 times more in Vermont 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· 25th of 51

$38,019

VT $61,660NM $19,055

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.