APR-DRG 004

Tracheostomy with extended mechanical ventilation and extensive procedure

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 41efcec26401
Generated: October 17, 2026

Original text from hospital filings

facility

Payers reporting APR-DRG 004

24 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.

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1	Humana facility · case rate · inpatient	10	$58,302	$54,902	$31,009 – $81,117
2	UnitedHealthcare fee schedule · inpatient · +3 other terms	10	$129,227	$135,525	$63,138 – $250,584
3	Aetna fee schedule · inpatient · +1 other terms	9	$78,797	$84,269	$39,462 – $156,615
4	Highmark fee schedule · inpatient · +1 other terms	9	$89,828	$96,066	$44,986 – $178,541
5	Molina facility · case rate · inpatient · +4 other terms	9	$49,967	$74,007	$31,009 – $228,727
6	Blue Cross Blue Shield facility · case rate · inpatient · +5 other terms	7	$197,089	$314,758	$80,300 – $385,052
7	Aetna Better Health facility · case rate · inpatient · +1 other terms	6	$49,967	$65,458	$31,009 – $400,345
8	Anthem facility · case rate · inpatient	3	$312,771	$351,824	$81,882 – $389,623
9	Caresource facility · case rate · inpatient	2	$216,540	$306,311	$81,882 – $389,623
10	Medicaid facility · case rate · inpatient · +1 other terms	2	$246,584	$246,584	$84,759 – $389,623
11	WellCare facility · case rate · inpatient · +1 other terms	2	$86,431	$86,431	$69,006 – $103,855
12	Amerihealth Caritas facility · case rate · inpatient	1	$81,882	$81,882	$81,882 – $81,882
13	Bcbs Ny case rate · inpatient · +1 other terms	1	$343,145	$343,145	$343,145 – $343,145
14	Carefirst facility · case rate · inpatient	1	$385,052	$385,052	$385,052 – $385,052
15	Cigna case rate · inpatient	1	$288,774	$288,774	$288,774 – $288,774
16	Excellus case rate · inpatient · +1 other terms	1	$174,723	$174,723	$109,136 – $343,145
17	Kaiser other · inpatient · +1 other terms	1	$87,744	$87,744	$61,911 – $129,525
18	Medical Mutual case rate · inpatient	1	$163,513	$163,513	$163,513 – $163,513
19	Premera facility · case rate · inpatient	1	$385,052	$385,052	$385,052 – $385,052
20	Regence facility · case rate · inpatient	1	$385,052	$385,052	$385,052 – $385,052
21	Sanford Health Plan case rate · inpatient	1	$157,165	$157,165	$134,958 – $181,043
22	Superior Healthplan facility · case rate · inpatient	1	$145,992	$145,992	$145,992 – $145,992
23	Ucare facility · case rate · inpatient	1	$115,476	$115,476	$91,903 – $139,049
24	Wellmark facility · case rate · inpatient	1	$385,052	$385,052	$385,052 – $385,052