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Major joint replacement w MCC

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

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Hospitals
27
Min
$95.00
Median
$21,808
Max
$28,215
Range multiplier
297.0×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield1868$2,284.00$14,865$66,38329.1×
UnitedHealthcare1939$2,352.52$19,214$55,61423.6×
Medicare834$21,772$26,417$44,4772.0×
Aetna1327$6,781.00$25,226$65,5519.7×
TRICARE1623$1,982.00$19,134$38,53319.4×
Humana1822$19,594$21,019$31,6961.6×
smarthealth99$1,506.00$26,633$35,31623.5×
WellCare99$19,023$19,023$25,8761.4×
Ambetter88$31,388$31,388$40,8651.3×
First Health88$7,300.00$7,300.00$11,0001.5×
Medicare Advantage88$19,023$19,023$22,8301.2×
hap38$23,469$31,422$60,4022.6×
blue mcr replacement77$19,023$19,023$19,0231.0×
Cigna77$10,470$10,470$10,4701.0×
facility billing - op77$19,023$19,023$19,0231.0×
healthspring mcr replacement77$19,404$19,404$19,4041.0×
occunet77$42,802$42,802$42,8021.0×
Oscar Health77$30,437$30,437$30,4371.0×
pcc employee77$10,815$10,815$10,8151.0×
priority health47$23,703$36,232$56,6632.4×
Molina35$23,862$25,876$34,9331.5×
bcbsm35$23,469$25,876$68,6822.9×
mi amish medical board55$25,038$30,299$31,9681.3×
meridian health plan of mi34$30,000$31,948$34,9331.2×
mclaren health33$23,469$23,862$25,8761.1×
bcn33$23,469$23,862$25,8761.1×
bcbsm/bcn33$73,315$81,939$87,6501.2×
cca health michigan33$23,469$23,862$25,8761.1×
CareSource33$23,469$23,862$25,8761.1×
vitalcore physicians group of mi33$43,417$44,145$47,8711.1×
erickson22$23,862$24,869$25,8761.1×
upper pennisula health plan22$2,986.35$3,175.95$3,365.541.1×
amerihealth michigan22$23,385$24,372$25,3581.1×
pace of se mi22$22,669$23,626$24,5821.1×
mount carmel health plan22$23,862$24,869$25,8761.1×
cofinity group health22$46,396$53,380$60,3631.3×
thomas pace11$23,469$23,469$23,4691.0×
total health care priority health11$22,830$22,830$22,8301.0×
united behavioral health11$22,830$22,830$22,8301.0×
uphp11$92.50$92.50$92.501.0×
communitycare (select)11$2,734.80$2,734.80$2,734.801.0×
communitycare (standard)11$2,734.80$2,734.80$2,734.801.0×
connect health benefit11$4,568.00$4,568.00$4,568.001.0×
employer direct healthcare11$35,473$35,473$35,4731.0×
national healthcare solutions, inc11$43,659$43,659$43,6591.0×
harbor health plan11$22,830$22,830$22,8301.0×
va community care network11$2,110.00$2,110.00$2,110.001.0×
honest hmo11$22,830$22,830$22,8301.0×
immergrun inc11$25,815$25,815$25,8151.0×
kempton group administrators11$2,284.00$2,284.00$2,284.001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
St. Francis HospitalEscanabaMI3$92.50$95.00$66,383
Ascension St John HospitalDetroitMI13$1,506.00$5,674.50$18,736
Aspirus Keweenaw HospitalLauriumMI1$2,986.35$2,986.35$2,986.35
Mclaren Greater LansingLansingMI6$94,896$47,448$20,995$28,215$53,251
Mclaren Lapeer RegionLapeerMI6$143,346$71,673$21,042$27,462$50,559
Mclaren FlintFlintMI6$80,243$40,122$20,876$26,742$49,641
Mclaren Northern MichiganPetoskeyMI6$36,883$18,442$21,052$26,544$61,295
Tawas St. Joseph HospitalTawasMI9$25,226$26,487$40,865
Henry Ford HospitalDetroitMI20$24,582$25,876$87,650
W.a. Foote Memorial HospitalJacksonMI16$23,469$23,929$81,939
Henry Ford Health Wyandotte HospitalWyandotteMI20$22,669$23,862$73,315
Garden City Hospital OsteopathicGarden CityMI19$27,286$22,830$23,401$65,803
Mclaren Port HuronPort HuronMI5$49,033$24,517$20,989$22,322$61,332
Bay Regional Medical CenterBay CityMI7$87,257$43,628$17,555$21,808$41,112
Borgess-Pipp Health CenterPlainwellMI17$7,300.00$19,023$44,380
Ascension Borgess HospitalKalamazooMI17$7,300.00$19,023$44,380
Genesys Regional Medical Ctr.Grand BlancMI17$7,300.00$19,023$44,380
Ascension Providence Rochester HospiRochesterMI17$7,300.00$19,023$44,380
Ascension Standish HospitalStandishMI17$7,300.00$19,023$44,380
Ascension Borgess-Lee HospitalDowagiacMI17$7,300.00$19,023$44,380
Ascension Allegan HospitalAlleganMI17$7,300.00$19,023$44,380
Aspirus Ironwood HospitalIronwoodMI2$3,365.54$12,129$20,892
Sparrow Clinton HospitalSt. JohnsMI0$93,821$23,455
Sparrow EatonCharlotteMI0$93,821$23,455
Mh - Mercy CampusMuskegonMI0
North Ottawa Community HospitalGrand HavenMI0
Carson City HospitalCarson CityMI0$93,821$23,455

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.