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Pennsylvania rates for MS-DRG 494

Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc

Facilitymedian $31,623 · 10th–90th $16,596–$45,7090%10%10th90th$31,623$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
$18,197.01 / $33,113.11 / $46,773.51
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,782.79 / $29,512.09 / $50,118.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $31,622.78 / $44,668.36
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35,481.34 / $35,481.34 / $42,657.95
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $33,113.11 / $40,738.03
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $31,622.78 / $43,651.58
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,197.01 / $30,902.95 / $45,708.82
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,489.63 / $16,218.10 / $26,915.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,623.41 / $25,703.96 / $46,773.51