Johnson Memorial Health — Pricing

197 procedures published in this hospital's Machine-Readable File (MRF) — 184 with a comparable price, 13 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.

Procedures published 197
Lowest published price $812
Average published price $8,996
Highest published price $77,181

Gross charges are the hospital's listed price — almost no one pays this amount. Your actual cost depends on your insurance plan. Use the cash price (when shown) as a guide for what uninsured patients are charged, and contact the hospital or your insurer for a personalized cost estimate.

Showing all 197 procedures

Published charges

Showing all 184 procedures with a comparable published price (gross, cash, or insurance-negotiated median), sorted highest to lowest. Green = this hospital prices below the median; amber = above.

DRG Description Published price Cash price vs. IN median vs. National median vs Medicare
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $77,181 $61,745 $39,000 +98% $23,924 +223% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $70,577 $56,462 $15,496 +355% $18,253 +287% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $69,377 $55,501 $13,191 +426% $14,337 +384% —
501 SOFT TISSUE PROCEDURES WITH CC $46,666 $37,333 $37,975 +23% $37,975 +23% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $39,165 $31,332 $36,381 +8% $30,358 +29% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $37,371 $29,897 $69,008 −46% $63,984 −42% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $34,292 $27,433 $56,394 −39% $56,394 −39% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $33,667 $26,934 $45,897 −27% $39,747 −15% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $32,186 $25,749 $69,061 −53% $75,103 −57% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $26,562 $21,249 $65,920 −60% $56,519 −53% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $26,151 $20,921 $41,705 −37% $33,792 −23% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $22,810 $18,248 $36,194 −37% $27,369 −17% —
398 APPENDIX PROCEDURES WITH CC $22,101 $17,681 $48,238 −54% $39,107 −43% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $21,647 $17,317 $18,862 +15% $25,307 −14% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $21,326 $17,061 $82,635 −74% $67,764 −69% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $21,097 $16,877 $52,123 −60% $57,855 −64% —
399 APPENDIX PROCEDURES WITHOUT CC/MCC $20,630 $16,504 $40,977 −50% $30,314 −32% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $20,409 $16,327 $67,630 −70% $70,540 −71% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $19,140 $15,312 $47,197 −59% $51,985 −63% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $18,627 $14,902 $36,228 −49% $38,094 −51% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $18,582 $14,866 $61,413 −70% $49,197 −62% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $18,378 $14,703 $41,471 −56% $30,930 −41% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $17,537 $14,029 $75,004 −77% $87,018 −80% —
602 CELLULITIS WITH MCC $17,468 $13,974 $23,217 −25% $29,347 −40% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $16,702 $13,362 $36,099 −54% $33,165 −50% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $16,423 $13,138 $55,188 −70% $46,477 −65% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $15,500 $12,400 $18,465 −16% $29,524 −48% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $14,954 $11,964 $29,262 −49% $32,689 −54% —
571 SKIN DEBRIDEMENT WITH CC $14,851 $11,880 $33,203 −55% $34,901 −57% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $14,691 $11,753 $32,509 −55% $24,022 −39% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $12,515 $10,012 $24,740 −49% $19,815 −37% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $12,360 $9,888 $43,105 −71% $54,313 −77% —
999 UNGROUPABLE $11,857 $9,486 $12,752 −7% $28,822 −59% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $11,697 $9,358 $92,818 −87% $54,824 −79% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $11,631 $9,305 $55,328 −79% $51,172 −77% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $11,088 $8,871 $29,263 −62% $45,059 −75% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $10,117 $8,093 $8,572 +18% $9,076 +11% —
200 PNEUMOTHORAX WITH CC $9,834 $7,867 $16,159 −39% $20,573 −52% —
639 DIABETES WITHOUT CC/MCC $9,828 $7,863 $15,521 −37% $13,910 −29% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $9,726 $7,781 $16,720 −42% $19,287 −50% —
375 DIGESTIVE MALIGNANCY WITH CC $9,541 $7,633 $22,647 −58% $27,219 −65% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $9,407 $7,525 $24,511 −62% $24,136 −61% —
947 SIGNS AND SYMPTOMS WITH MCC $9,243 $7,394 $21,794 −58% $25,474 −64% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $9,041 $7,233 $16,985 −47% $25,208 −64% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $8,964 $7,171 $22,604 −60% $32,399 −72% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $8,882 $7,106 $17,659 −50% $25,426 −65% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $8,811 $7,049 $40,602 −78% $42,881 −79% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $8,596 $6,877 $46,490 −82% $43,524 −80% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $8,566 $6,852 $18,211 −53% $14,134 −39% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $8,488 $6,790 $58,044 −85% $62,961 −87% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $8,330 $6,664 $31,150 −73% $31,840 −74% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $8,329 $6,664 $20,640 −60% $21,886 −62% —
199 PNEUMOTHORAX WITH MCC $8,304 $6,643 $22,672 −63% $31,491 −74% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $8,226 $6,581 $32,661 −75% $44,989 −82% —
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC $8,211 $6,569 $26,747 −69% $30,814 −73% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $7,858 $6,286 $18,396 −57% $20,777 −62% —
637 DIABETES WITH MCC $7,531 $6,025 $27,419 −73% $28,819 −74% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $7,408 $5,927 $18,441 −60% $24,480 −70% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $7,338 $5,871 $19,690 −63% $22,024 −67% —
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $7,334 $5,867 $43,225 −83% $34,887 −79% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $7,198 $5,758 $24,866 −71% $22,713 −68% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $7,114 $5,691 $46,751 −85% $72,782 −90% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $7,099 $5,679 $56,422 −87% $71,755 −90% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $6,979 $5,584 $52,676 −87% $44,117 −84% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $6,926 $5,541 $17,464 −60% $21,806 −68% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $6,878 $5,503 $49,328 −86% $42,119 −84% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $6,854 $5,483 $15,590 −56% $15,607 −56% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $6,848 $5,478 $19,298 −65% $18,623 −63% —
682 RENAL FAILURE WITH MCC $6,737 $5,389 $23,404 −71% $27,854 −76% —
304 HYPERTENSION WITH MCC $6,613 $5,290 $21,606 −69% $24,185 −73% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $6,604 $5,283 $16,174 −59% $20,732 −68% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $6,577 $5,262 $62,273 −89% $58,832 −89% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $6,439 $5,152 $18,351 −65% $14,128 −54% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $6,436 $5,149 $23,622 −73% $30,275 −79% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $6,430 $5,144 $37,285 −83% $33,490 −81% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $6,404 $5,123 $22,038 −71% $19,483 −67% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $6,341 $5,073 $24,245 −74% $23,749 −73% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $6,013 $4,811 $62,733 −90% $48,680 −88% —
313 CHEST PAIN $5,994 $4,795 $15,899 −62% $15,962 −62% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $5,865 $4,692 $19,278 −70% $22,850 −74% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $5,645 $4,516 $23,205 −76% $28,134 −80% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $5,514 $4,412 $17,772 −69% $16,865 −67% —
865 VIRAL ILLNESS WITH MCC $5,486 $4,389 $15,617 −65% $26,088 −79% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $5,473 $4,379 $24,871 −78% $23,469 −77% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $5,462 $4,369 $13,194 −59% $17,103 −68% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $5,390 $4,312 $25,516 −79% $20,084 −73% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $5,389 $4,312 $40,244 −87% $31,978 −83% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $5,283 $4,227 $24,118 −78% $29,757 −82% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $5,282 $4,226 $15,718 −66% $14,368 −63% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $5,262 $4,210 $14,806 −64% $18,002 −71% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $5,203 $4,162 $18,049 −71% $18,017 −71% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $5,202 $4,162 $18,307 −72% $25,731 −80% —
305 HYPERTENSION WITHOUT MCC $5,131 $4,104 $16,571 −69% $17,144 −70% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $5,125 $4,100 $24,488 −79% $24,202 −79% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $5,032 $4,025 $16,375 −69% $19,579 −74% —
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $5,002 $4,002 $29,370 −83% $27,118 −82% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $4,990 $3,992 $42,213 −88% $52,405 −90% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $4,968 $3,974 $16,290 −70% $17,466 −72% ≈96% of Medicare
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $4,965 $3,972 $15,999 −69% $17,322 −71% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $4,872 $3,897 $20,030 −76% $20,488 −76% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $4,833 $3,866 $24,427 −80% $24,190 −80% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $4,757 $3,805 $12,769 −63% $13,090 −64% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $4,744 $3,795 $25,094 −81% $26,488 −82% —
292 HEART FAILURE AND SHOCK WITH CC $4,708 $3,766 $15,730 −70% $16,212 −71% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $4,707 $3,766 $6,470 −27% $14,284 −67% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $4,663 $3,731 $17,102 −73% $17,522 −73% —
683 RENAL FAILURE WITH CC $4,642 $3,713 $17,473 −73% $18,620 −75% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $4,588 $3,670 $16,360 −72% $18,803 −76% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $4,551 $3,640 $21,192 −79% $22,781 −80% —
157 DENTAL AND ORAL DISEASES WITH MCC $4,545 $3,636 $22,312 −80% $27,457 −83% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $4,470 $3,576 $25,867 −83% $25,704 −83% ≈53% of Medicare
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $4,459 $3,568 $32,245 −86% $35,237 −87% ≈35% of Medicare
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $4,443 $3,554 $22,848 −81% $28,780 −85% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $4,421 $3,537 $19,816 −78% $21,449 −79% —
638 DIABETES WITH CC $4,410 $3,528 $18,826 −77% $18,821 −77% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $4,341 $3,473 $26,958 −84% $22,560 −81% —
811 RED BLOOD CELL DISORDERS WITH MCC $4,300 $3,440 $27,285 −84% $27,934 −85% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $4,275 $3,420 $14,751 −71% $16,745 −74% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $4,274 $3,419 $29,133 −85% $35,714 −88% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $4,266 $3,413 $17,757 −76% $15,600 −73% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $4,204 $3,363 $15,264 −72% $15,070 −72% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $4,184 $3,347 $13,914 −70% $13,318 −69% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $4,109 $3,287 $12,156 −66% $12,044 −66% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $4,077 $3,262 $17,444 −77% $18,204 −78% ≈77% of Medicare
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $4,073 $3,258 $9,888 −59% $12,381 −67% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $4,056 $3,245 $26,049 −84% $31,758 −87% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $4,038 $3,230 $16,977 −76% $19,096 −79% —
291 HEART FAILURE AND SHOCK WITH MCC $4,029 $3,223 $20,626 −80% $25,020 −84% ≈47% of Medicare
149 DYSEQUILIBRIUM $4,016 $3,213 $14,987 −73% $17,203 −77% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $3,948 $3,159 $15,663 −75% $17,727 −78% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $3,883 $3,107 $15,045 −74% $15,045 −74% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $3,868 $3,095 $27,589 −86% $23,571 −84% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $3,862 $3,089 $23,145 −83% $17,700 −78% —
340 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $3,846 $3,076 $19,474 −80% $16,240 −76% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $3,817 $3,053 $16,523 −77% $17,273 −78% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $3,777 $3,021 $30,263 −88% $32,502 −88% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $3,770 $3,016 $21,892 −83% $30,058 −87% —
312 SYNCOPE AND COLLAPSE $3,707 $2,965 $19,855 −81% $19,342 −81% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $3,688 $2,950 $10,272 −64% $11,633 −68% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $3,617 $2,894 $15,157 −76% $13,824 −74% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $3,588 $2,871 $19,687 −82% $22,982 −84% ≈46% of Medicare
389 GASTROINTESTINAL OBSTRUCTION WITH CC $3,583 $2,866 $14,848 −76% $17,388 −79% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $3,545 $2,836 $18,632 −81% $23,496 −85% —
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $3,540 $2,832 $23,953 −85% $26,158 −86% ≈39% of Medicare
643 ENDOCRINE DISORDERS WITH MCC $3,529 $2,823 $33,333 −89% $32,996 −89% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $3,377 $2,702 $21,896 −85% $20,278 −83% —
795 NORMAL NEWBORN $3,376 $2,701 $4,825 −30% $4,530 −25% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $3,357 $2,686 $31,663 −89% $28,967 −88% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $3,354 $2,683 $21,786 −85% $27,244 −88% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $3,297 $2,637 $14,348 −77% $17,367 −81% —
551 MEDICAL BACK PROBLEMS WITH MCC $3,281 $2,625 $17,266 −81% $31,086 −89% —
101 SEIZURES WITHOUT MCC $3,261 $2,609 $18,712 −83% $19,954 −84% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $3,164 $2,531 $18,693 −83% $32,483 −90% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $3,101 $2,481 $5,619 −45% $7,961 −61% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $3,097 $2,478 $19,032 −84% $21,213 −85% —
176 PULMONARY EMBOLISM WITHOUT MCC $3,096 $2,477 $17,693 −83% $18,081 −83% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $3,085 $2,468 $12,861 −76% $12,013 −74% —
071 OTHER CEREBROVASCULAR DISORDERS WITH CC $3,054 $2,443 $19,652 −84% $23,396 −87% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $3,039 $2,431 $13,279 −77% $13,384 −77% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $3,000 $2,400 $17,146 −83% $13,198 −77% —
694 URINARY STONES WITHOUT MCC $2,971 $2,377 $14,250 −79% $16,531 −82% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $2,969 $2,375 $15,208 −80% $16,837 −82% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $2,934 $2,348 $15,535 −81% $16,049 −82% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $2,860 — $61,186 −95% $43,398 −93% —
183 MAJOR CHEST TRAUMA WITH MCC $2,838 $2,271 $21,767 −87% $28,924 −90% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $2,827 $2,262 $14,066 −80% $12,279 −77% —
644 ENDOCRINE DISORDERS WITH CC $2,824 $2,259 $18,925 −85% $22,941 −88% —
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $2,780 $2,224 $13,447 −79% $16,654 −83% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $2,693 $2,154 $15,247 −82% $14,166 −81% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $2,684 $2,147 $25,993 −90% $32,204 −92% —
381 COMPLICATED PEPTIC ULCER WITH CC $2,665 $2,132 $21,721 −88% $24,177 −89% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $2,650 — $43,495 −94% $36,239 −93% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $2,648 $2,118 $16,300 −84% $13,892 −81% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $2,563 $2,050 $23,983 −89% $23,141 −89% —
913 TRAUMATIC INJURY WITH MCC $2,453 $1,962 $14,729 −83% $24,198 −90% —
504 FOOT PROCEDURES WITH CC $2,415 $1,932 $37,729 −94% $36,598 −93% —
603 CELLULITIS WITHOUT MCC $2,394 $1,915 $17,246 −86% $18,530 −87% —
919 COMPLICATIONS OF TREATMENT WITH MCC $2,366 $1,893 $26,999 −91% $29,031 −92% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $2,167 $1,734 $16,674 −87% $18,918 −89% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $1,936 — $30,570 −94% $36,237 −95% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $1,857 $1,486 $31,987 −94% $26,146 −93% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $1,706 $1,365 $29,027 −94% $24,561 −93% —
204 RESPIRATORY SIGNS AND SYMPTOMS $1,389 $1,111 $13,818 −90% $16,866 −92% —
885 PSYCHOSES $812 $812 $11,724 −93% $21,489 −96% —

Procedures with negotiated rates only

These 13 procedures have published per-payer insurance agreements but no single comparable dollar amount in the MRF — typically because the agreement is expressed as a percentage of charge, a fee schedule reference, or a contract algorithm. The number of payers indicates how many insurance plans have a negotiated rate on file.

DRG Description Insurance rate range Payers
187 PLEURAL EFFUSION WITH CC $1,005 – $11,297 9 plans
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $2,181 – $56,961 9 plans
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $1,725 – $18,300 · median $1,725 9 plans
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $1,545 – $52,497 9 plans
336 PERITONEAL ADHESIOLYSIS WITH CC $1,845 – $24,083 9 plans
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $2,592 – $50,170 9 plans
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $1,996 – $22,916 · median $1,996 9 plans
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $1,869 – $28,040 · median $1,869 9 plans
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $6,779 – $78,940 · median $6,779 9 plans
916 ALLERGIC REACTIONS WITHOUT MCC $809 – $7,610 · median $809 9 plans
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $6,555 – $9,628 · median $6,860 4 plans
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $13,082 – $19,215 · median $13,691 4 plans
881 DEPRESSIVE NEUROSES $7,316 – $10,746 · median $7,657 4 plans
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