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New York rates for MS-DRG 468

Revision of hip or knee replacement w/o CC/MCC

Facilitymedian $67,608 · 10th–90th $26,303$107,1520%10%10th90th$67,608$2.0K$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
$21,877.62 / $57,543.99 / $107,151.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $81,283.05 / $100,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48,977.88 / $75,857.76 / $100,000.00
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38,018.94 / $69,183.10 / $169,824.37
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25,118.86 / $25,118.86 / $25,118.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,782.79 / $60,255.96 / $102,329.30