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Washington rates for MS-DRG 469

Major joint replacement or reattachment of lower extremity w MCC

Facilitymedian $74,131 · 10th–90th $43,652–$125,8930%10%10th90th$74,131$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
$50,118.72 / $75,857.76 / $125,892.54
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36,307.81 / $58,884.37 / $81,283.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43,651.58 / $66,069.34 / $100,000.00
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36,307.81 / $52,480.75 / $57,543.99
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41,686.94 / $61,659.50 / $93,325.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36,307.81 / $64,565.42 / $87,096.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,302.68 / $60,255.96 / $87,096.36