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Texas rates for MS-DRG 461

Bilateral or multiple major joint procs of lower extremity w MCC

Facilitymedian $70,795 · 10th–90th $28,184–$128,8250%10%10th90th$70,795$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
$27,542.29 / $77,624.71 / $128,824.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29,512.09 / $63,095.73 / $112,201.85
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47,863.01 / $89,125.09 / $177,827.94
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199,526.23 / $199,526.23 / $199,526.23
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27,542.29 / $57,543.99 / $128,824.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $72,443.60 / $177,827.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23,442.29 / $50,118.72 / $112,201.85