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Major joint replacement w/o MCC

MS-DRG 470 · negotiated-rate distribution across hospitals in GA

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Hospitals
14
Min
$12,429
Median
$23,539
Max
$41,632
Range multiplier
3.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
healthpartners347$18,178$41,632$58,8673.2×
Blue Cross Blue Shield1142$73$22,247$56,951780.1×
Aetna1131$90$30,668$46,355515.1×
UnitedHealthcare1027$12,218$19,757$79,3276.5×
Cigna1127$85$21,400$53,910634.2×
Humana1120$12,303$31,533$48,8594.0×
WellCare78$12,097$16,934$20,9231.7×
Oscar Health77$19,356$26,156$26,1561.4×
devoted health66$13,996$18,834$20,3201.5×
Ambetter55$19,961$38,011$41,8452.1×
Kaiser Permanente44$13,996$18,834$19,7381.4×
optum44$13,996$18,834$19,7381.4×
clover health44$14,696$19,776$20,7251.4×
sonder health plans44$14,696$19,776$20,7251.4×
va community care network44$13,996$18,834$19,7381.4×
First Health23$95$7,300$14,155149.0×
TRICARE23$12,429$12,429$19,6001.6×
CareSource13$20,350$20,350$34,5241.7×
sonder health plan12$20,745$20,745$20,7451.0×
peach state12$18,161$19,255$20,3501.1×
riverwood behavioral health12$19,728$19,742$19,7571.0×
Health Net12$97$7,125.87$14,155145.9×
occunet11$27,219$27,219$27,2191.0×
pcc employee11$10,815$10,815$10,8151.0×
prime health services11$17,713$17,713$17,7131.0×
provider select11$18,078$18,078$18,0781.0×
rural arizona network11$14,155$14,155$14,1551.0×
smarthealth11$16,936$16,936$16,9361.0×
ubh optum11$19,757$19,757$19,7571.0×
united mine workers of america11$14,155$14,155$14,1551.0×
three rivers11$17,713$17,713$17,7131.0×
americas choice provider network11$17,713$17,713$17,7131.0×
arizona medical network11$14,155$14,155$14,1551.0×
banner health11$14,155$14,155$14,1551.0×
blue mcr replacement11$12,097$12,097$12,0971.0×
bridgeway health solutions11$14,155$14,155$14,1551.0×
centurion11$29,592$29,592$29,5921.0×
clear spring health plan11$19,728$19,728$19,7281.0×
corvel11$17,348$17,348$17,3481.0×
employer direct healthcare11$25,647$25,647$25,6471.0×
facility billing - op11$12,097$12,097$12,0971.0×
georgia workers’ compensation11$18,261$18,261$18,2611.0×
health choice pathway11$14,155$14,155$14,1551.0×
health management network11$14,155$14,155$14,1551.0×
healthspring mcr replacement11$12,339$12,339$12,3391.0×
imperial insurance11$14,862$14,862$14,8621.0×
Medicare11$19,728$19,728$19,7281.0×
Medicare Advantage11$12,097$12,097$12,0971.0×
Multiplan11$17,713$17,713$17,7131.0×
naphcare11$30,579$30,579$30,5791.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
NORTHEAST GEORGIA MEDICAL CENTERGAINESVILLEGA6$18,156$41,632$58,867
EMORY LONG TERM ACUTE CAREDECATURGA5$26,156$36,454$37,652
NGMC BARROWWINDERGA6$18,178$30,389$56,951
NGMC LUMPKIN LLCDAHLONEGAGA6$17,625$30,389$58,867
EMORY UNIVERSITY HOSPITAL MIDTOWNATLANTAGA14$19,446$23,539$41,845
EMORY UNIVERSITY HOSPITALATLANTAGA14$19,446$23,539$41,845
ST. JOSEPHS OF ATLANTAATLANTAGA14$13,996$22,801$40,029
EMORY DECATURDECATURGA14$17,930$22,801$40,029
SOUTHERN REGIONAL MEDICAL CENTERRIVERDALEGA28$19,728$12,303$19,838$34,524
WEST CENTRAL GA REGIONAL HOSPITALCOLUMBUSGA17$73$14,155$79,327
ST. MARYS SACRED HEART HOSPITALLAVONIAGA17$7,300$12,429$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.