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Major joint replacement w MCC

MS-DRG 469 · negotiated-rate distribution across hospitals in GA

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Hospitals
14
Min
$19,023
Median
$39,525
Max
$72,168
Range multiplier
3.8×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
healthpartners347$31,512$72,168$102,0463.2×
Blue Cross Blue Shield1142$92$36,299$98,7231073.1×
Aetna1131$90$53,162$80,356892.8×
UnitedHealthcare1027$16,961$27,894$126,5387.5×
Cigna1127$85$37,097$93,4531099.4×
Humana1120$8,958.2$54,663$84,6979.5×
WellCare78$19,023$26,759$30,2451.6×
Oscar Health77$30,437$45,341$45,3411.5×
devoted health66$22,009$27,328$28,5331.3×
Ambetter55$31,388$55,505$60,4911.9×
Kaiser Permanente44$22,009$27,357$28,5331.3×
optum44$22,009$27,357$28,5331.3×
clover health44$23,109$28,725$29,9601.3×
sonder health plans44$23,109$28,725$29,9601.3×
va community care network44$22,009$27,357$28,5331.3×
First Health23$95$7,300$24,539258.3×
TRICARE23$19,134$19,134$30,7351.6×
CareSource13$28,522$28,522$48,3801.7×
sonder health plan12$29,075$29,075$29,0751.0×
peach state12$28,522$30,003$31,4841.1×
riverwood behavioral health12$27,646$27,668$27,6911.0×
Health Net12$97$12,318$24,539253.0×
occunet11$42,802$42,802$42,8021.0×
pcc employee11$10,815$10,815$10,8151.0×
prime health services11$31,344$31,344$31,3441.0×
provider select11$31,990$31,990$31,9901.0×
rural arizona network11$24,539$24,539$24,5391.0×
smarthealth11$26,633$26,633$26,6331.0×
ubh optum11$27,691$27,691$27,6911.0×
united mine workers of america11$24,539$24,539$24,5391.0×
three rivers11$31,344$31,344$31,3441.0×
americas choice provider network11$31,344$31,344$31,3441.0×
arizona medical network11$24,539$24,539$24,5391.0×
banner health11$24,539$24,539$24,5391.0×
blue mcr replacement11$19,023$19,023$19,0231.0×
bridgeway health solutions11$24,539$24,539$24,5391.0×
centurion11$41,468$41,468$41,4681.0×
clear spring health plan11$27,646$27,646$27,6461.0×
corvel11$30,698$30,698$30,6981.0×
employer direct healthcare11$35,939$35,939$35,9391.0×
facility billing - op11$19,023$19,023$19,0231.0×
georgia workers’ compensation11$32,314$32,314$32,3141.0×
health choice pathway11$24,539$24,539$24,5391.0×
health management network11$24,539$24,539$24,5391.0×
healthspring mcr replacement11$19,404$19,404$19,4041.0×
imperial insurance11$25,766$25,766$25,7661.0×
Medicare11$27,646$27,646$27,6461.0×
Medicare Advantage11$19,023$19,023$19,0231.0×
Multiplan11$31,344$31,344$31,3441.0×
naphcare11$42,851$42,851$42,8511.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
NORTHEAST GEORGIA MEDICAL CENTERGAINESVILLEGA6$27,182$72,168$102,046
EMORY LONG TERM ACUTE CAREDECATURGA5$45,341$63,193$65,269
NGMC LUMPKIN LLCDAHLONEGAGA6$26,128$52,486$102,046
NGMC BARROWWINDERGA6$27,894$43,758$98,723
EMORY UNIVERSITY HOSPITALATLANTAGA14$28,533$39,525$69,390
EMORY DECATURDECATURGA14$26,181$39,525$69,390
EMORY UNIVERSITY HOSPITAL MIDTOWNATLANTAGA14$28,533$39,525$69,390
ST. JOSEPHS OF ATLANTAATLANTAGA14$22,009$39,525$69,390
SOUTHERN REGIONAL MEDICAL CENTERRIVERDALEGA28$27,645$8,958.2$31,029$48,380
WEST CENTRAL GA REGIONAL HOSPITALCOLUMBUSGA17$85$24,539$126,538
ST. MARYS SACRED HEART HOSPITALLAVONIAGA17$7,300$19,023$44,380
SOUTHWELL MEDICALADELGA0
MEMORIAL HOSPITALBAINBRIDGEGA0
UNION GENERAL HOSPITALBLAIRSVILLEGA0

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.