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Pennsylvania rates for MS-DRG 461

Bilateral or multiple major joint procs of lower extremity w MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49,806.40 / $90,295.50 / $123,306.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,946.00 / $86,666.81 / $140,251.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42,186.00 / $76,217.39 / $123,697.46
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91,007.99 / $91,007.99 / $110,509.71
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113,889.54 / $113,889.54 / $228,207.12
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49,718.00 / $84,479.80 / $122,025.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42,186.00 / $73,820.42 / $123,697.46
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $46,699.43 / $68,206.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,652.81 / $71,272.00 / $126,277.87