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Texas rates for MS-DRG 469

Major joint replacement or reattachment of lower extremity w MCC

Facilitymedian $38,905 · 10th–90th $18,621–$70,7950%5%10%10th90th$38,905$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
$18,620.87 / $43,651.58 / $70,794.58
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $33,113.11 / $66,069.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27,542.29 / $44,668.36 / $91,201.08
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109,647.82 / $109,647.82 / $109,647.82
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $30,902.95 / $70,794.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,915.35 / $38,904.51 / $97,723.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,197.01 / $28,840.32 / $60,255.96