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Washington rates for MS-DRG 461

Bilateral or multiple major joint procs of lower extremity w MCC

Facilitymedian $134,896 · 10th–90th $91,201–$229,0870%10%10th90th$134,896$5.0K$10.0K$20.0K$50.0K$100.0K$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
$93,325.43 / $141,253.75 / $295,120.92
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61,659.50 / $117,489.76 / $165,958.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81,283.05 / $120,226.44 / $181,970.09
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81,283.05 / $93,325.43 / $100,000.00
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79,432.82 / $114,815.36 / $177,827.94
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67,608.30 / $123,026.88 / $165,958.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47,863.01 / $109,647.82 / $158,489.32