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California rates for MS-DRG 469

Major joint replacement or reattachment of lower extremity w MCC

Facilitymedian $72,444 · 10th–90th $16,982$97,7240%20%10th90th$72,444$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
$28,183.83 / $56,234.13 / $100,000.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $85,113.80 / $95,499.26
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15,135.61 / $52,480.75 / $107,151.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25,703.96 / $52,480.75 / $107,151.93
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $17,782.79
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109,647.82 / $109,647.82 / $109,647.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $57,543.99 / $109,647.82
Sutter Health Plus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $56,234.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $43,651.58 / $91,201.08