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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
$50,118.72 / $91,201.08 / $128,824.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,840.32 / $91,201.08 / $165,958.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,668.36 / $83,176.38 / $123,026.88
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97,723.72 / $97,723.72 / $117,489.76
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37,153.52 / $89,125.09 / $109,647.82
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125,892.54 / $125,892.54 / $125,892.54
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,118.72 / $85,113.80 / $123,026.88
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $56,234.13 / $91,201.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $66,069.34 / $114,815.36