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California rates for MS-DRG 461

Bilateral or multiple major joint procs of lower extremity w MCC

Facilitymedian $134,896 · 10th–90th $33,884–$158,4890%20%40%10th90th$134,896$100.0$500.0$2.0K$10.0K$50.0K$200.0K

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
$32,359.37 / $102,329.30 / $173,780.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34,673.69 / $138,038.43 / $154,881.66
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,302.68 / $95,499.26 / $177,827.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $93,325.43 / $173,780.08
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $346.74
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199,526.23 / $199,526.23 / $199,526.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30,902.95 / $95,499.26 / $194,984.46
Sutter Health Plus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89,125.09 / $89,125.09 / $89,125.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $58,884.37 / $165,958.69