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Pennsylvania rates for MS-DRG 462

Bilateral or multiple major joint procs of lower extremity w/o MCC

Facilitymedian $43,652 · 10th–90th $23,988–$64,5650%10%10th90th$43,652$2.0K$5.0K$10.0K$20.0K$50.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25,118.86 / $43,651.58 / $66,069.34
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $63,095.73 / $87,096.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23,988.33 / $42,657.95 / $60,255.96
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $46,773.51 / $57,543.99
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,498.45 / $43,651.58 / $53,703.18
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35,481.34 / $52,480.75 / $70,794.58
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23,988.33 / $43,651.58 / $63,095.73
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,952.62 / $23,442.29 / $40,738.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,623.41 / $34,673.69 / $64,565.42