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New Jersey rates for MS-DRG 469

Major joint replacement or reattachment of lower extremity w MCC

Facilitymedian $72,444 · 10th–90th $40,738–$97,7240%10%10th90th$72,444$5.0K$10.0K$20.0K$50.0K$100.0K

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
$42,657.95 / $74,131.02 / $97,723.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35,481.34 / $72,443.60 / $97,723.72
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100,000.00 / $100,000.00 / $100,000.00
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42,657.95 / $67,608.30 / $102,329.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $21,379.62 / $83,176.38