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Major joint replacement w MCC

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

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Hospitals
11
Min
$28,003
Median
$35,452
Max
$95,332
Range multiplier
3.4×

By payer (41 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Aetna1024$21,044$51,598$95,4034.5×
Empire BCBS422$23,097$71,843$351,39515.2×
UnitedHealthcare821$28,025$40,081$351,39512.5×
Cigna717$29,560$75,336$351,39511.9×
Emblem Health516$29,560$82,652$351,39511.9×
Blue Cross Blue Shield510$663.07$29,781$55,79084.1×
Humana88$28,025$33,616$351,39512.5×
Medicare27$22,701$28,025$28,0251.2×
WellCare66$28,569$32,513$351,39512.3×
Healthfirst35$32,177$41,641$351,39510.9×
oxford35$32,177$98,370$351,39510.9×
oscar34$65,099$65,099$74,8651.2×
cdphp24$29,560$72,167$114,8783.9×
fidelis44$30,151$37,326$351,39511.7×
geisinger health plan24$29,560$49,436$72,8192.5×
mvp33$29,560$32,364$34,8691.2×
local 119933$66,148$87,734$90,9961.4×
magnacare33$52,927$110,962$117,3552.2×
health first22$29,560$30,962$32,3641.1×
vns22$41,641$196,518$351,3958.4×
horizon12$72,951$79,388$85,8241.2×
upmc22$29,560$30,962$32,3641.1×
Medicare Advantage12$20,234$22,718$25,2031.2×
metroplus22$41,641$196,518$351,3958.4×
capital district physicians health plan cdphp11$28,003$28,003$28,0031.0×
prime health services11$32,364$32,364$32,3641.0×
st. regis11$34,869$34,869$34,8691.0×
TRICARE11$26,838$26,838$26,8381.0×
brighton11$88,327$88,327$88,3271.0×
VA Health11$34,869$34,869$34,8691.0×
emblemhealth11$38,179$38,179$38,1791.0×
1199seiu national benefit funds11$49,691$49,691$49,6911.0×
elderplan 131611$28,025$28,025$28,0251.0×
fidelis care11$34,869$34,869$34,8691.0×
wellpath11$52,303$52,303$52,3031.0×
elderplan11$351,395$351,395$351,3951.0×
capital district physicians' health plan11$34,869$34,869$34,8691.0×
longevity11$32,177$32,177$32,1771.0×
capital district physicians health plan mcr adv11$28,003$28,003$28,0031.0×
northwell direct11$66,730$66,730$66,7301.0×
1199 seiu11$31,263$31,263$31,2631.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
NEW YORK EYE AND EAR INFIRMARYNEW YORKNY15$31,263$95,332$351,395
NEW YORK PRESBYTERIAN HOSPITALNEW YORKNY15$41,641$74,865$119,505
MEMORIAL HOSPITAL FOR CANCER AND ALLNEW YORKNY3$21,044$74,671$129,724
SOUTH NASSAU COMMUNITIES HOSPITALOCEANSIDENY12$23,097$65,099$117,160
NASSAU UNIVERSITY MEDICAL CENTEREAST MEADOWNY6$29,858$39,657$52,927
ELIZABETHTOWN COMMUNITY HOSPITALELIZABETHTOWNNY1$35,452$35,452$35,452
CHAMPLAIN VALLEY PHYSICIANS HOSPITALPLATTSBURGHNY10$32,965$34,869$78,344
GARNET HEALTH MEDICAL CENTERMIDDLETOWNNY17$32,364$32,364$117,355
GARNET HEALTH MEDICAL CENTER - CATSKHARRISNY15$29,560$29,560$121,994
FREDRICK FERRIS THOMPSON HOSPITALCANANDAIGUANY6$28,025$22,701$28,025$40,081
ADIRONDACK MEDICAL CENTERSARANAC LAKENY8$45,404$28,150$663.07$28,003$30,003

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.