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Major joint replacement w MCC

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

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Hospitals
12
Min
$25,141
Median
$29,961
Max
$60,834
Range multiplier
2.4×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield728$6,690.00$39,779$96,27514.4×
UnitedHealthcare723$23,944$31,538$88,4183.7×
mgb hlth partners [11110]420$15,292$26,335$64,5844.2×
Cigna713$4,268.00$44,691$81,41419.1×
Aetna410$20,609$31,894$106,0665.1×
correctional care [11003]38$27,094$43,066$46,4251.7×
mgb connectorcare [10506]28$13,334$23,256$56,1624.2×
institution [10406]36$758.07$14,290$37,16949.0×
tufts [11201]35$3,880.00$6,958.00$7,654.002.0×
amerihealth24$26,937$46,325$76,9962.9×
fallon mcaid carelon hlth [29]33$1,814.19$2,064.74$2,064.741.1×
commonwealth care mcr [10115]33$28,448$29,961$29,9611.1×
medical mutual13$23,944$55,450$68,1222.8×
Humana33$23,944$28,371$34,0411.4×
hsno/free care [10801]33$27,821$37,169$37,1691.3×
tufts dual [10111]33$27,821$37,169$37,1691.3×
tufts connectorcare [10507]33$27,821$37,169$37,1691.3×
Medicare33$27,821$37,169$37,1691.3×
senior whole health [10110]33$28,990$30,532$30,5321.1×
mgb mcr [10124]33$28,448$29,961$29,9611.1×
fallon connectorcare [10503]33$22,803$65,921$65,9212.9×
qualcare inc12$6,640.00$6,803.00$6,966.001.0×
buckeye health plan12$23,944$32,324$40,7041.7×
CareSource12$23,944$30,474$37,0051.5×
eternalhealth mcr replace [10116]22$29,961$29,961$29,9611.0×
fallon mcr [10105]22$29,961$29,961$29,9611.0×
geisinger12$28,646$32,522$36,3981.3×
harvard pilgrim mcr supp [20203]22$29,961$29,961$29,9611.0×
Medicaid22$9,381.39$9,381.39$9,381.391.0×
Molina12$25,141$38,735$52,3292.1×
pennsylvania health and wellness12$28,922$30,103$31,2841.1×
tufts mcr supp [20209]22$29,961$29,961$29,9611.0×
WellCare22$31,538$49,640$67,7412.1×
wellpoint12$1,885.00$17,963$34,04118.1×
First Health11$60.00$60.00$60.001.0×
keystone first11$28,095$28,095$28,0951.0×
upmc health plan11$28,922$28,922$28,9221.0×
fidelis care11$34,041$34,041$34,0411.0×
fallon mcr supp [20202]11$28,448$28,448$28,4481.0×
medigold11$23,944$23,944$23,9441.0×
fallon carelon hlth [28]11$2,023.12$2,023.12$2,023.121.0×
Emblem Health11$64,384$64,384$64,3841.0×
elder health11$33,053$33,053$33,0531.0×
valor health plan11$23,944$23,944$23,9441.0×
naphcare11$41,317$41,317$41,3171.0×
optum11$23,944$23,944$23,9441.0×
partners11$31,226$31,226$31,2261.0×
vaya11$31,538$31,538$31,5381.0×
perennial advantage11$25,141$25,141$25,1411.0×
point comfort11$27,544$27,544$27,5441.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Beth Israel Deaconess - PlymouthPlymouthMA13$3,470.00$60.00$60,834$106,066
High Point HospitalMiddleboroughMA12$26,937$31,538$46,682
Umass Memorial Medical CenterWorcesterMA22$106,958$106,958$758.07$29,961$65,921
Marlborough HospitalMarlboroughMA22$106,958$106,958$758.07$29,961$65,921
Chestnut Hill Benevolent AssociationChestnut HillMA17$27,544$28,922$65,123
Healthalliance-ClintonLeominsterMA22$102,173$102,173$758.07$27,821$55,252
Harrington Memorial HospitalSouthbridgeMA1$43,828$43,828$15,292$26,335$55,252
Hospital For Behavioral MedicineWorcesterMA16$23,944$25,141$68,773
North Adams Regional HospitalNorth AdamsMA0
Berkshire Medical CenterPittsfieldMA0
Fairview HospitalGreat BarringtonMA0
North Shore Medical CenterSalemMA0

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.