Pineville Community Health Center — Pricing

244 procedures published in this hospital's Machine-Readable File (MRF) — 220 with a comparable price, 24 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 244
Lowest published price $340
Average published price $10,477
Highest published price $154,731

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 244 procedures

Published charges

Showing all 220 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. KY median vs. National median
535 FRACTURES OF HIP AND PELVIS WITH MCC $154,731 $154,731 $33,107 +367% $24,552 +530%
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $112,037 $112,037 $100,074 +12% $70,467 +59%
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $109,409 $109,409 $65,200 +68% $52,075 +110%
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $79,494 $79,494 $74,394 +7% $58,280 +36%
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $79,312 $79,312 $44,022 +80% $42,881 +85%
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $68,546 $68,546 $31,193 +120% $45,877 +49%
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $63,129 $63,129 $116,959 −46% $58,707 +8%
444 DISORDERS OF THE BILIARY TRACT WITH MCC $49,837 $49,837 $38,406 +30% $34,273 +45%
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $47,412 $47,412 $28,160 +68% $31,017 +53%
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $44,360 $44,360 $35,421 +25% $45,333 −2%
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $43,455 $43,455 $60,868 −29% $41,955 +4%
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $41,269 $41,269 $29,304 +41% $46,090 −10%
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $40,289 $40,289 $36,918 +9% $50,139 −20%
570 SKIN DEBRIDEMENT WITH MCC $40,125 $40,125 $60,276 −33% $52,435 −23%
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $37,338 $37,338 $80,371 −54% $65,653 −43%
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $31,717 $31,717 $45,317 −30% $26,770 +18%
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $28,219 $28,219 $42,329 −33% $51,985 −46%
348 ANAL AND STOMAL PROCEDURES WITH CC $27,073 $27,073 $38,329 −29% $27,947 −3%
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC $26,756 $26,756 $26,756 +0% $35,692 −25%
592 SKIN ULCERS WITH MCC $25,883 $25,883 $29,882 −13% $33,246 −22%
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $23,209 $23,209 $23,768 −2% $16,776 +38%
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $21,796 $21,796 $31,466 −31% $27,275 −20%
885 PSYCHOSES $21,496 $21,496 $21,489 +0% $21,729 −1%
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $20,744 $20,744 $37,691 −45% $35,628 −42%
637 DIABETES WITH MCC $20,309 $20,309 $32,615 −38% $30,100 −33%
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $20,100 $20,100 $16,213 +24% $17,737 +13%
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $19,462 $19,462 $24,871 −22% $26,682 −27%
505 FOOT PROCEDURES WITHOUT CC/MCC $19,144 $19,144 $26,308 −27% $34,937 −45%
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $18,065 $18,065 $24,273 −26% $18,204 −1%
682 RENAL FAILURE WITH MCC $17,898 $17,898 $35,346 −49% $29,064 −38%
297 CARDIAC ARREST, UNEXPLAINED WITH CC $17,435 $17,435 $50,570 −66% $12,336 +41%
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $16,651 $16,651 $40,130 −59% $34,459 −52%
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $16,405 $16,405 $30,644 −46% $27,543 −40%
291 HEART FAILURE AND SHOCK WITH MCC $16,123 $16,123 $27,950 −42% $26,776 −40%
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $15,820 $15,820 $34,854 −55% $38,101 −58%
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $15,782 $15,782 $22,205 −29% $23,551 −33%
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $15,712 $15,712 $29,232 −46% $24,386 −36%
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $14,456 $14,456 $15,121 −4% $18,072 −20%
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $13,870 $13,870 $40,467 −66% $30,828 −55%
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $13,826 $13,826 $27,183 −49% $18,807 −26%
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $13,712 $13,712 $29,466 −53% $27,316 −50%
030 SPINAL PROCEDURES WITHOUT CC/MCC $13,094 $13,094 $32,077 −59% $45,866 −71%
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $12,744 $12,744 $20,876 −39% $20,781 −39%
389 GASTROINTESTINAL OBSTRUCTION WITH CC $12,552 $12,552 $17,991 −30% $17,578 −29%
292 HEART FAILURE AND SHOCK WITH CC $12,345 $12,345 $22,544 −45% $16,371 −25%
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $12,093 $12,093 $28,603 −58% $22,024 −45%
540 OSTEOMYELITIS WITH CC $11,972 $11,972 $31,282 −62% $26,676 −55%
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $11,931 $11,931 $14,937 −20% $16,552 −28%
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $11,852 $11,852 $27,659 −57% $21,056 −44%
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $11,836 $11,836 $31,922 −63% $33,707 −65%
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $11,765 $11,765 $22,651 −48% $30,502 −61%
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $11,227 $11,227 $21,201 −47% $25,279 −56%
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $11,022 $11,022 $23,966 −54% $27,394 −60%
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $10,852 $10,852 $22,580 −52% $24,944 −56%
378 GASTROINTESTINAL HEMORRHAGE WITH CC $9,859 $9,859 $33,279 −70% $22,098 −55%
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $9,793 $9,793 $36,090 −73% $37,387 −74%
693 URINARY STONES WITH MCC $9,653 $9,653 $31,040 −69% $23,892 −60%
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $9,599 $9,599 $52,078 −82% $37,842 −75%
100 SEIZURES WITH MCC $9,422 $9,422 $34,570 −73% $35,481 −73%
180 RESPIRATORY NEOPLASMS WITH MCC $9,387 $9,387 $41,406 −77% $36,658 −74%
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $9,152 $9,152 $21,120 −57% $19,096 −52%
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $9,098 $9,098 $29,948 −70% $31,159 −71%
184 MAJOR CHEST TRAUMA WITH CC $8,944 $8,944 $20,832 −57% $22,432 −60%
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $8,867 $8,867 $31,730 −72% $28,050 −68%
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $8,852 $8,852 $24,661 −64% $22,888 −61%
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $8,669 $8,669 $32,815 −74% $39,106 −78%
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $8,667 $8,667 $35,896 −76% $32,496 −73%
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $8,656 $8,656 $32,631 −73% $26,580 −67%
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $8,456 $8,456 $22,138 −62% $21,275 −60%
947 SIGNS AND SYMPTOMS WITH MCC $8,286 $8,286 $32,529 −75% $27,401 −70%
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $8,237 $8,237 $32,532 −75% $19,227 −57%
089 CONCUSSION WITH CC $8,170 $8,170 $17,109 −52% $18,821 −57%
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $8,155 $8,155 $32,399 −75% $30,571 −73%
302 ATHEROSCLEROSIS WITH MCC $7,677 $7,677 $19,372 −60% $22,446 −66%
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $7,600 $7,600 $21,581 −65% $17,303 −56%
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $7,533 $7,533 $24,877 −70% $27,285 −72%
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $7,410 $7,410 $29,140 −75% $20,463 −64%
919 COMPLICATIONS OF TREATMENT WITH MCC $7,400 $7,400 $36,329 −80% $31,105 −76%
534 FRACTURES OF FEMUR WITHOUT MCC $7,387 $7,387 $17,559 −58% $17,559 −58%
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $7,382 $7,382 $17,357 −57% $16,565 −55%
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $7,296 $7,296 $32,091 −77% $30,235 −76%
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $7,233 $7,233 $17,483 −59% $17,483 −59%
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $7,107 $7,107 $21,410 −67% $21,449 −67%
445 DISORDERS OF THE BILIARY TRACT WITH CC $6,869 $6,869 $31,283 −78% $23,319 −71%
183 MAJOR CHEST TRAUMA WITH MCC $6,850 $6,850 $23,796 −71% $29,933 −77%
546 CONNECTIVE TISSUE DISORDERS WITH CC $6,826 $6,826 $18,220 −63% $25,700 −73%
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $6,798 $6,798 $42,046 −84% $33,985 −80%
300 PERIPHERAL VASCULAR DISORDERS WITH CC $6,646 $6,646 $23,406 −72% $20,422 −67%
375 DIGESTIVE MALIGNANCY WITH CC $6,483 $6,483 $24,270 −73% $27,277 −76%
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $6,446 $6,446 $39,353 −84% $38,666 −83%
683 RENAL FAILURE WITH CC $6,395 $6,395 $16,816 −62% $19,130 −67%
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $6,385 $6,385 $44,584 −86% $49,710 −87%
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $6,199 $6,199 $20,809 −70% $21,363 −71%
602 CELLULITIS WITH MCC $6,192 $6,192 $36,196 −83% $30,598 −80%
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $5,915 $5,915 $16,503 −64% $13,361 −56%
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $5,907 $5,907 $14,668 −60% $16,520 −64%
638 DIABETES WITH CC $5,853 $5,853 $19,243 −70% $19,661 −70%
176 PULMONARY EMBOLISM WITHOUT MCC $5,451 $5,451 $24,353 −78% $18,081 −70%
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $5,444 $5,444 $19,614 −72% $14,368 −62%
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $5,425 $5,425 $15,589 −65% $15,589 −65%
551 MEDICAL BACK PROBLEMS WITH MCC $5,405 $5,405 $29,332 −82% $34,017 −84%
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $5,394 $5,394 $18,064 −70% $18,002 −70%
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $5,348 $5,348 $33,054 −84% $23,940 −78%
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $5,242 $5,242 $28,685 −82% $33,633 −84%
312 SYNCOPE AND COLLAPSE $5,163 $5,163 $22,612 −77% $19,342 −73%
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $4,895 $4,895 $34,577 −86% $17,700 −72%
386 INFLAMMATORY BOWEL DISEASE WITH CC $4,873 $4,873 $29,116 −83% $22,033 −78%
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $4,789 $4,789 $16,396 −71% $14,128 −66%
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $4,786 $4,786 $21,605 −78% $22,506 −79%
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $4,597 $4,597 $17,275 −73% $15,183 −70%
202 BRONCHITIS AND ASTHMA WITH CC/MCC $4,535 $4,535 $22,232 −80% $17,724 −74%
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $4,494 $4,494 $12,454 −64% $12,454 −64%
186 PLEURAL EFFUSION WITH MCC $4,428 $4,428 $41,699 −89% $33,834 −87%
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $4,357 $4,357 $11,294 −61% $12,324 −65%
090 CONCUSSION WITHOUT CC/MCC $4,151 $4,151 $14,321 −71% $15,412 −73%
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $4,089 $4,089 $15,603 −74% $19,924 −79%
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $4,026 $4,026 $14,654 −73% $16,998 −76%
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $4,010 $4,010 $32,757 −88% $25,463 −84%
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $3,988 $3,988 $16,076 −75% $18,602 −79%
694 URINARY STONES WITHOUT MCC $3,936 $3,936 $22,004 −82% $17,345 −77%
101 SEIZURES WITHOUT MCC $3,825 $3,825 $17,956 −79% $20,461 −81%
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $3,741 $3,741 $15,311 −76% $16,968 −78%
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $3,664 $3,664 $38,806 −91% $39,955 −91%
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $3,638 $3,638 $18,755 −81% $17,620 −79%
311 ANGINA PECTORIS $3,608 $3,608 $19,453 −81% $15,502 −77%
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $3,509 $3,509 $20,048 −82% $15,038 −77%
103 HEADACHES WITHOUT MCC $3,476 $3,476 $20,630 −83% $21,280 −84%
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $3,467 $3,467 $41,432 −92% $20,926 −83%
304 HYPERTENSION WITH MCC $3,465 $3,465 $21,518 −84% $26,080 −87%
181 RESPIRATORY NEOPLASMS WITH CC $3,344 $3,344 $29,493 −89% $23,573 −86%
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $3,188 $3,188 $26,858 −88% $23,617 −87%
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $3,134 $3,134 $29,543 −89% $20,181 −84%
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $2,994 $2,994 $24,084 −88% $19,305 −84%
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $2,989 $2,989 $18,375 −84% $17,601 −83%
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $2,952 $2,952 $14,064 −79% $14,064 −79%
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $2,931 $2,931 $21,563 −86% $26,280 −89%
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $2,886 $2,886 $24,302 −88% $27,633 −90%
811 RED BLOOD CELL DISORDERS WITH MCC $2,849 $2,849 $24,733 −88% $28,226 −90%
149 DYSEQUILIBRIUM $2,843 $2,843 $21,737 −87% $18,096 −84%
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $2,785 $2,785 $14,290 −81% $14,290 −81%
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $2,752 $2,752 $15,310 −82% $18,528 −85%
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $2,677 $2,677 $29,825 −91% $23,749 −89%
644 ENDOCRINE DISORDERS WITH CC $2,667 $2,667 $20,072 −87% $23,198 −89%
200 PNEUMOTHORAX WITH CC $2,656 $2,656 $17,568 −85% $21,368 −88%
123 NEUROLOGICAL EYE DISORDERS $2,627 $2,627 $13,618 −81% $19,745 −87%
596 MAJOR SKIN DISORDERS WITHOUT MCC $2,572 $2,572 $17,226 −85% $17,226 −85%
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $2,526 $2,526 $16,857 −85% $20,232 −88%
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $2,497 $2,497 $29,080 −91% $23,141 −89%
313 CHEST PAIN $2,404 $2,404 $17,918 −87% $16,440 −85%
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $2,367 $2,367 $12,903 −82% $14,716 −84%
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $2,313 $2,313 $17,494 −87% $17,674 −87%
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $2,283 $2,283 $19,935 −89% $17,038 −87%
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $2,281 $2,281 $12,593 −82% $12,593 −82%
552 MEDICAL BACK PROBLEMS WITHOUT MCC $2,215 $2,215 $25,521 −91% $21,396 −90%
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $2,211 $2,211 $27,695 −92% $33,255 −93%
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $2,199 $2,199 $18,806 −88% $17,322 −87%
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $2,067 $2,067 $25,095 −92% $20,506 −90%
152 OTITIS MEDIA AND URI WITH MCC $2,018 $2,018 $17,922 −89% $20,247 −90%
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $2,006 $2,006 $13,574 −85% $16,699 −88%
303 ATHEROSCLEROSIS WITHOUT MCC $1,930 $1,930 $20,526 −91% $14,927 −87%
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $1,882 $1,882 $20,530 −91% $19,842 −91%
948 SIGNS AND SYMPTOMS WITHOUT MCC $1,881 $1,881 $22,268 −92% $17,921 −90%
603 CELLULITIS WITHOUT MCC $1,816 $1,816 $21,796 −92% $18,530 −90%
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $1,804 $1,804 $15,326 −88% $14,648 −88%
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $1,770 $1,770 $16,819 −89% $15,452 −89%
606 MINOR SKIN DISORDERS WITH MCC $1,762 $1,762 $33,799 −95% $27,975 −94%
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $1,756 $1,756 $15,243 −88% $17,733 −90%
914 TRAUMATIC INJURY WITHOUT MCC $1,738 $1,738 $20,851 −92% $15,855 −89%
881 DEPRESSIVE NEUROSES $1,723 $1,723 $14,026 −88% $15,058 −89%
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $1,717 $1,717 $19,874 −91% $15,019 −89%
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $1,639 $1,639 $20,145 −92% $26,051 −94%
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $1,620 $1,620 $12,578 −87% $13,651 −88%
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $1,600 $1,600 $12,235 −87% $12,252 −87%
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $1,564 $1,564 $20,885 −93% $13,384 −88%
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $1,560 $1,560 $13,288 −88% $17,124 −91%
607 MINOR SKIN DISORDERS WITHOUT MCC $1,540 $1,540 $29,306 −95% $15,889 −90%
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $1,535 $1,535 $25,981 −94% $22,148 −93%
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $1,530 $1,530 $11,752 −87% $14,638 −90%
305 HYPERTENSION WITHOUT MCC $1,443 $1,443 $27,094 −95% $18,086 −92%
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $1,438 $1,438 $19,117 −92% $18,488 −92%
594 SKIN ULCERS WITHOUT CC/MCC $1,433 $1,433 $14,209 −90% $14,209 −90%
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $1,394 $1,394 $11,484 −88% $12,895 −89%
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $1,369 $1,369 $20,001 −93% $26,510 −95%
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $1,342 $1,342 $14,615 −91% $13,824 −90%
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $1,338 $1,338 $17,650 −92% $15,600 −91%
639 DIABETES WITHOUT CC/MCC $1,280 $1,280 $18,007 −93% $13,910 −91%
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $1,265 $1,265 $11,921 −89% $14,549 −91%
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $1,264 $1,264 $10,171 −88% $14,250 −91%
887 OTHER MENTAL DISORDER DIAGNOSES $1,223 $1,223 $18,631 −93% $20,616 −94%
812 RED BLOOD CELL DISORDERS WITHOUT MCC $1,192 $1,192 $22,569 −95% $20,488 −94%
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $1,167 $1,167 $15,868 −93% $17,298 −93%
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $1,149 $1,149 $11,421 −90% $11,421 −90%
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $1,086 $1,086 $15,788 −93% $14,689 −93%
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $1,037 $1,037 $15,461 −93% $15,837 −93%
541 OSTEOMYELITIS WITHOUT CC/MCC $1,037 $1,037 $14,549 −93% $15,215 −93%
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $1,006 $1,006 $13,791 −93% $18,126 −94%
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $987 $987 $8,927 −89% $8,927 −89%
153 OTITIS MEDIA AND URI WITHOUT MCC $977 $977 $20,533 −95% $14,583 −93%
916 ALLERGIC REACTIONS WITHOUT MCC $954 $954 $15,322 −94% $13,942 −93%
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $943 $943 $16,847 −94% $19,657 −95%
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $940 $940 $10,316 −91% $12,999 −93%
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $929 $929 $12,960 −93% $23,206 −96%
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $895 $895 $12,234 −93% $12,460 −93%
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $891 $891 $27,428 −97% $18,150 −95%
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $876 $876 $12,204 −93% $14,797 −94%
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $875 $875 $26,359 −97% $19,569 −96%
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $872 $872 $20,206 −96% $17,118 −95%
204 RESPIRATORY SIGNS AND SYMPTOMS $857 $857 $13,720 −94% $18,004 −95%
684 RENAL FAILURE WITHOUT CC/MCC $846 $846 $13,284 −94% $13,642 −94%
151 EPISTAXIS WITHOUT MCC $843 $843 $13,032 −94% $13,032 −94%
951 OTHER FACTORS INFLUENCING HEALTH STATUS $828 $828 $10,553 −92% $10,160 −92%
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $810 $810 $14,675 −94% $15,428 −95%
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $737 $737 $11,909 −94% $11,909 −94%
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $721 $721 $12,771 −94% $12,559 −94%
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $702 $702 $9,940 −93% $9,940 −93%
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $662 $662 $11,755 −94% $13,633 −95%
201 PNEUMOTHORAX WITHOUT CC/MCC $641 $641 $11,982 −95% $14,053 −95%
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $609 $609 $10,975 −94% $10,975 −94%
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $514 $514 $11,071 −95% $11,071 −95%
950 AFTERCARE WITHOUT CC/MCC $340 — $25,102 −99% $13,527 −97%

Procedures with negotiated rates only

These 24 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
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC — 11 plans
158 DENTAL AND ORAL DISEASES WITH CC $767 – $6,214 · median $1,167 11 plans
188 PLEURAL EFFUSION WITHOUT CC/MCC — 11 plans
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC — 11 plans
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC — 11 plans
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $590 – $4,653 · median $899 11 plans
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC — 11 plans
550 SEPTIC ARTHRITIS WITHOUT CC/MCC — 11 plans
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC — 11 plans
642 INBORN AND OTHER DISORDERS OF METABOLISM — 11 plans
697 URETHRAL STRICTURE — 11 plans
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC — 11 plans
795 NORMAL NEWBORN — 11 plans
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC — 11 plans
813 COAGULATION DISORDERS — 11 plans
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC — 11 plans
864 FEVER AND INFLAMMATORY CONDITIONS — 11 plans
866 VIRAL ILLNESS WITHOUT MCC — 11 plans
882 NEUROSES EXCEPT DEPRESSIVE $400 – $7,334 11 plans
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC — 11 plans
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY — 11 plans
935 NON-EXTENSIVE BURNS — 11 plans
949 AFTERCARE WITH CC/MCC — 11 plans
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION — 11 plans
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