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HIV with Major Related Condition with Major Complications

Pennsylvania rates for MS-DRG 974

HIV with Major Related Condition with MCC

Rates data updated July 2026.

How much does HIV with Major Related Condition with Major Complications cost?

$43,652

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $43,652 for this service. Most negotiated rates run $30,903 to $54,954.

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 $43,652 · 10th to 90th $24,547 to $63,096
$10K$20K$50Kfacility $43,652

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
$26,302.68
Median
$44,668.36
Typical High
$63,095.73
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$26,915.35
Median
$51,286.14
Typical High
$75,857.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$24,547.09
Median
$43,651.58
Typical High
$63,095.73
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$51,286.14
Median
$51,286.14
Typical High
$61,659.50
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$47,863.01
Typical High
$58,884.37
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$45,708.82
Median
$63,095.73
Typical High
$93,325.43
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$26,302.68
Median
$43,651.58
Typical High
$63,095.73
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$22,387.21
Median
$27,542.29
Typical High
$44,668.36
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$37,153.52
Typical High
$67,608.30

Where Pennsylvania sits

The same service costs 3.4 times more in New York than in Michigan. 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· 27th of 51

$43,652

NY $72,444MI $21,380

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.