Payer comparison · CPT 461 · FAR ROCKAWAY, NY

461 — Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc

What each payer pays ST JOHN'S EPISCOPAL HOSPITAL AT SOUTH SHORE (CCN 330395) for this procedure, and where each sits versus the all-payer median at this facility. Find your plan to see whether you're above or below the market here.

$83,370 All-payer median here

24 payer/plan-name variants

← This hospital National rates for 461 →

Per-payer negotiated rate at this facility. Use the column headers to sort, the filter row to narrow results.
Payer / plan	Median negotiated	vs all-payer median	Rate rows

EmblemHealth	$115,197	38.2%	4
Magnacare	$110,258	32.3%	1
MultiPlan	$106,254	27.4%	1
Metroplus	$106,254	27.4%	5
Centene	$106,254	27.4%	4
Healthfirst	$106,254	27.4%	5
AFFINITY HEALTH PLAN	$106,254	27.4%	2
Healthplus	$106,254	27.4%	1
Hamaspik	$90,399	8.4%	2
Cigna Healthcare	$83,692	0.4%	1
1199 NATIONAL BENEFIT FUND	$83,048	-0.4%	1
Blue Cross Blue Shield Association	$82,532	-1.0%	3
Molina Healthcare	$81,999	-1.6%	1
Aetna	$79,065	-5.2%	3
Longevity	$74,545	-10.6%	1
Lucida	$74,545	-10.6%	1
CenterLight Health System, Inc.	$74,545	-10.6%	1
WellCare Health Plans	$74,545	-10.6%	1
Centers Plan For Healthy Living	$74,545	-10.6%	1
Humana	$74,545	-10.6%	1
Village Care Max	$74,545	-10.6%	1
Elderplan, Inc.	$74,545	-10.6%	1
Vns	$72,681	-12.8%	2
UnitedHealthcare	$70,334	-15.6%	2

Median over current-blob negotiated rates (COALESCE of standard / median / min–max midpoint, $0.01–$5M sentinel guard). Payers are canonical-grouped where a mapping exists; unmapped regional-plan name variants may appear as separate rows.