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Nationwide rates for MS-DRG 469

Major joint replacement or reattachment of lower extremity w MCC

Facilitymedian $33,113 · 10th–90th $10,715–$83,1760%5%10%10th90th$33,113$2.0$20.0$200.0$2.0K$20.0K$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
$26,302.68 / $50,118.72 / $87,096.36
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24,547.09 / $54,954.09 / $89,125.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $22,387.21 / $66,069.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,782.79 / $38,904.51 / $75,857.76

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