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Pennsylvania rates for MS-DRG 485

Knee procedures w pdx of infection w MCC

Facilitymedian $52,481 · 10th–90th $26,915–$74,1310%10%10th90th$52,481$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
$29,512.09 / $53,703.18 / $75,857.76
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $61,659.50 / $93,325.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,183.83 / $48,977.88 / $67,608.30
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57,543.99 / $57,543.99 / $69,183.10
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23,442.29 / $52,480.75 / $64,565.42
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,302.68 / $61,659.50 / $97,723.72
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $52,480.75 / $74,131.02
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $25,703.96 / $38,018.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,623.41 / $41,686.94 / $75,857.76