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Knee Procedures with Pdx of Infection with Complications

Pennsylvania rates for MS-DRG 486

Knee procedures w pdx of infection w CC

Rates data updated July 2026.

How much does Knee Procedures with Pdx of Infection with Complications cost?

$31,623

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $31,623 for this service. Most negotiated rates run $20,417 to $39,811.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $31,623 · 10th to 90th $17,378 to $46,774
$10K$20K$50K$100Kfacility $31,623

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$19,054.61
Median
$34,673.69
Typical High
$46,773.51
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$40,738.03
Typical High
$58,884.37
Cigna
Setting
Facility
Modifier
Global
Typical Low
$17,378.01
Median
$33,113.11
Typical High
$45,708.82
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$37,153.52
Median
$37,153.52
Typical High
$44,668.36
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$15,135.61
Median
$34,673.69
Typical High
$42,657.95
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$26,302.68
Median
$34,673.69
Typical High
$45,708.82
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$19,054.61
Median
$31,622.78
Typical High
$46,773.51
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$18,620.87
Typical High
$28,183.83
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$26,915.35
Typical High
$48,977.88

Where Pennsylvania sits

The same service costs 3.2 times more in New York than in New Mexico. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 26th of 51

$31,623

NY $54,954NM $16,982

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.