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Nationwide rates for MS-DRG 461

Bilateral or multiple major joint procs of lower extremity w MCC

Facilitymedian $44,668 · 10th–90th $10,471–$138,0380%5%10th90th$44,668$5.0$50.0$500.0$5.0K$50.0K$500.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $89,125.09 / $158,489.32
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38,904.51 / $97,723.72 / $158,489.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $22,387.21 / $79,432.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $69,183.10 / $138,038.43

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