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Diabetes with Major Complications

Pennsylvania rates for MS-DRG 637

Diabetes with MCC

Rates data updated July 2026.

How much does Diabetes with Major Complications cost?

$21,380

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $21,380 for this service. Most negotiated rates run $14,125 to $26,915.

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 $21,380 · 10th to 90th $11,749 to $31,623
$2.0K$5.0K$10.0K$20.0K$50.0Kfacility $21,380

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
$13,182.57
Median
$23,442.29
Typical High
$31,622.78
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$27,542.29
Typical High
$38,904.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$22,908.68
Typical High
$30,902.95
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$25,118.86
Median
$25,118.86
Typical High
$30,902.95
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$23,988.33
Typical High
$29,512.09
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$13,182.57
Median
$22,387.21
Typical High
$31,622.78
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$12,882.50
Median
$21,379.62
Typical High
$31,622.78
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$11,220.18
Median
$13,489.63
Typical High
$22,387.21
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$18,197.01
Typical High
$33,884.42

Where Pennsylvania sits

The same service costs 6.3 times more in Montana than in New Mexico. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $21,380 · 28th of 51
MT $72,444NM $11,482

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.