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Pennsylvania rates for MS-DRG 486

Knee procedures w pdx of infection w CC

Facilitymedian $34,674 · 10th–90th $18,621–$48,9780%10%10th90th$34,674$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
$19,054.61 / $34,673.69 / $50,118.72
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $40,738.03 / $58,884.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,197.01 / $33,113.11 / $45,708.82
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37,153.52 / $37,153.52 / $44,668.36
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,498.45 / $34,673.69 / $43,651.58
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,302.68 / $34,673.69 / $45,708.82
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,054.61 / $33,884.42 / $47,863.01
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,791.08 / $16,982.44 / $24,547.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,623.41 / $26,915.35 / $48,977.88