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Pennsylvania rates for MS-DRG 489

Knee procedures w/o pdx of infection w/o CC/MCC

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,222.10 / $18,258.59 / $26,942.80
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,407.89 / $20,407.89 / $20,407.89
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,921.00 / $22,179.32 / $32,880.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,774.23 / $17,422.08 / $26,105.47
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,402.63 / $18,402.63 / $22,346.05
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,556.86 / $25,765.17 / $32,433.07
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,071.29 / $18,258.59 / $26,608.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,196.85 / $15,099.14 / $26,105.47
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $9,852.57 / $13,766.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,404.00 / $16,007.09 / $26,758.00