APR-DRG 040

Major spinal disorders and injuries treatment

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

SPINAL DISORDERS AND INJURIES,MODERATE

Payers reporting APR-DRG 040

23 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	Aetna fee schedule · inpatient	9	$13,520	$14,458	$7,837 – $25,100
2	Highmark fee schedule · inpatient · +2 other terms	9	$15,412	$16,483	$8,934 – $28,615
3	UnitedHealthcare fee schedule · inpatient · +2 other terms	9	$21,631	$23,133	$12,539 – $40,161
4	Molina facility · case rate · inpatient · +3 other terms	7	$6,931	$11,358	$5,819 – $35,724
5	Aetna Better Health facility · case rate · inpatient	6	$6,931	$15,098	$5,819 – $91,730
6	Humana facility · case rate · inpatient	6	$6,931	$11,841	$5,819 – $60,948
7	Blue Cross Blue Shield fee schedule · inpatient · +5 other terms	3	$22,350	$23,234	$19,889 – $28,330
8	Caresource case rate · inpatient	2	$13,483	$13,483	$13,303 – $13,663
9	Medicaid facility · case rate · inpatient	2	$12,102	$12,102	$10,203 – $14,001
10	Anthem facility · case rate · inpatient · +1 other terms	1	$35,249	$35,249	$23,775 – $46,723
11	Bcbs Ny case rate · inpatient · +1 other terms	1	$24,386	$24,386	$24,386 – $24,386
12	Carefirst facility · case rate · inpatient · +1 other terms	1	$35,249	$35,249	$23,775 – $46,723
13	Cigna case rate · inpatient	1	$20,522	$20,522	$20,522 – $20,522
14	Excellus case rate · inpatient · +2 other terms	1	$12,417	$12,417	$7,756 – $24,386
15	Kaiser other · inpatient · +1 other terms	1	$14,296	$14,296	$8,839 – $23,643
16	Medical Mutual case rate · inpatient	1	$11,620	$11,620	$11,620 – $11,620
17	Premera facility · case rate · inpatient · +1 other terms	1	$35,249	$35,249	$23,775 – $46,723
18	Regence facility · case rate · inpatient · +1 other terms	1	$35,249	$35,249	$23,775 – $46,723
19	Sanford Health Plan case rate · inpatient	1	$43,811	$43,811	$37,621 – $50,467
20	Superior Healthplan facility · case rate · inpatient	1	$27,568	$27,568	$21,685 – $33,451
21	Ucare facility · case rate · inpatient	1	$11,061	$11,061	$11,061 – $11,061
22	WellCare case rate · inpatient · +1 other terms	1	$8,291	$8,291	$8,291 – $8,291
23	Wellmark facility · case rate · inpatient · +1 other terms	1	$34,181	$34,181	$21,613 – $46,723