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Major joint replacement w MCC

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

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Hospitals
22
Min
$28,853
Median
$42,865
Max
$60,834
Range multiplier
2.1×

By payer (48 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield2195$85.00$39,503$102,6431207.6×
Aetna2174$25,762$75,311$197,0577.6×
UnitedHealthcare2173$26,561$69,950$150,9945.7×
horizon971$6,542.00$67,601$182,42427.9×
Cigna2147$29,972$77,298$147,7394.9×
amerihealth2037$22,614$53,329$99,8414.4×
WellCare2029$25,762$33,241$67,7412.6×
qualcare inc815$5,565.00$6,765.00$61,43711.0×
Humana1212$26,041$31,159$34,9031.3×
wellpoint812$1,885.00$26,569$34,04118.1×
clover health1111$26,041$31,003$34,2381.3×
amerigroup910$25,762$29,479$38,6171.5×
clover99$28,338$32,088$42,4791.5×
oxford99$103,608$106,037$139,5471.3×
brighton health plan99$107,932$107,932$133,5101.2×
seoul medical group99$28,853$32,671$43,2511.5×
vaccn99$23,702$26,979$39,3321.7×
karna99$36,025$40,570$53,1651.5×
First Health88$60.00$60.00$60.001.0×
Emblem Health88$39,809$50,394$64,3841.6×
fidelis care88$26,041$29,634$34,0411.3×
qualcare26$80,469$108,233$108,2331.3×
Medicare46$28,819$29,748$33,2411.2×
optum health36$23,337$28,064$33,6981.4×
jeff nj amerihealth_ibc14$25,236$35,007$53,3712.1×
Ambetter44$36,797$61,704$68,1441.9×
wellpoint full dual advantage33$30,100$30,100$33,2411.1×
oxford health plans33$76,100$76,100$76,1001.0×
braven health33$30,100$30,100$33,2411.1×
horizon nj total care33$30,100$30,100$33,2411.1×
healthspring33$31,003$31,003$34,2381.1×
horizon nj health33$18,074$18,074$18,0741.0×
jefferson health plan33$32,207$32,207$35,5681.1×
ubh22$25,818$27,494$29,1711.1×
geisinger health plan12$32,303$70,030$107,7583.3×
point of comfort refugee resettlement11$28,819$28,819$28,8191.0×
provider partners health plan11$30,837$30,837$30,8371.0×
optum va ccn11$28,819$28,819$28,8191.0×
naphcare11$46,111$46,111$46,1111.0×
Medicare Advantage11$29,700$29,700$29,7001.0×
st agnes11$28,819$28,819$28,8191.0×
inspira life11$28,819$28,819$28,8191.0×
innovage11$29,396$29,396$29,3961.0×
va_champus_tricare11$28,819$28,819$28,8191.0×
ibc main line health11$36,024$36,024$36,0241.0×
ibc employee benefit11$36,024$36,024$36,0241.0×
devoted health participation11$30,260$30,260$30,2601.0×
allwell pa health_wellness ma11$31,701$31,701$31,7011.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Newark Beth Israel Medical CenterNewarkNJ13$3,470.00$60.00$60,834$106,066
Jersey City Medical CenterJersey CityNJ13$5,589.00$60.00$59,698$98,613
Community Medical CenterToms RiverNJ13$2,426.00$60.00$56,825$88,073
Cooperman Barnabas Medical CenterLivingstonNJ13$3,319.00$60.00$56,371$88,583
Monmouth Medical CenterLong BranceNJ13$3,629.00$60.00$55,738$87,238
Robert Wood Johnson Hospital @ HamiHamiltonNJ13$3,233.00$60.00$54,712$83,117
Robert Wood Johnson University HospiNew BrunswickNJ13$3,233.00$60.00$54,712$83,117
Robert Wood Johnson Univ Hosp @ SomSomervilleNJ13$2,486.00$60.00$53,926$116,405
Jfk University Medical CenterEdisonNJ16$11,497$46,606$197,057
Hackensack University Medical CenterHackensackNJ16$11,497$46,606$197,057
Palisades Medical CenterNorth BergenNJ14$39,332$11,497$42,865$123,505
Inspira Medical Center VinelandVinelandNJ17$18,074$35,568$102,643
Hmh -Ocean Medical CenterBrickNJ14$26,979$15,110$34,553$125,194
Inspira Medical Center ElmerElmerNJ17$18,074$32,207$102,643
Jersey Shore University Med CtrNeptuneNJ16$27,730$16,183$32,088$182,424
Inspira Medical Center Woodbury IncWoodburyNJ17$18,074$31,906$102,643
Kennedy University HospitalCherry HillNJ22$32,213$25,236$31,701$107,758
Bayshore Medical CenterHolmdelNJ14$27,730$6,542.00$29,110$134,450
Raritan Bay Medical CenterPerth AmboyNJ14$27,730$6,542.00$29,110$134,450
Riverview Medical CenterRed BankNJ15$27,730$14,547$28,916$123,567
Southern Ocean Medical CenterManahawkinNJ14$23,702$6,542.00$28,853$124,547
West Jersey Health SystemVoorheesNJ0

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.