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Open Biopsy Of The Main Shoulder Joint

South Dakota rates for HCPCS 23100

The ball-and-socket joint of the shoulder is opened through an incision so the surgeon can look inside and take a tissue sample for laboratory testing. The sample usually comes from the lining of the joint. It is done to identify infection, inflammation, or an unexplained growth inside the joint.

Rates data updated October 2026.

How much does Open Biopsy Of The Main Shoulder Joint cost?

$2,585

Typical total for the visit. In South Dakota, October 2026.

Insurers have agreed to pay about $2,585 for this procedure. That total is two separate charges: $1,072 to the doctor who performs it, and $1,514 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,072$776 to $1,259
Facility feeThe hospital or surgery center$1,514$851 to $1,698

How much rates vary

Facilitymedian $1,514 · 10th to 90th $724 to $2,239Professionalmedian $1,072 · 10th to 90th $537 to $1,380
$500$1K$2Kfacility $1,514professional $1,072

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$501.19
Median
$3,090.30
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$436.52
Typical High
$562.34
Cigna
Setting
Facility
Modifier
None
Typical Low
$758.58
Median
$1,348.96
Typical High
$2,137.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$851.14
Median
$1,122.02
Typical High
$1,479.11
Medica
Setting
Facility
Modifier
None
Typical Low
$645.65
Median
$1,174.90
Typical High
$1,819.70
Medica
Setting
Professional
Modifier
None
Typical Low
$467.74
Median
$1,122.02
Typical High
$3,801.89
Midlands
Setting
Professional
Modifier
None
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,122.02
Midlands
Setting
Facility
Modifier
None
Typical Low
$954.99
Median
$1,445.44
Typical High
$2,238.72
Midlands
Setting
Professional
Modifier
None
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,096.48
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$616.60
Median
$776.25
Typical High
$1,023.29
United
Setting
Facility
Modifier
None
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,819.70
United
Setting
Professional
Modifier
None
Typical Low
$467.74
Median
$977.24
Typical High
$1,380.38
Wellmark
Setting
Professional
Modifier
None
Typical Low
$1,023.29
Median
$1,071.52
Typical High
$1,258.93

Where South Dakota sits

The same service costs 4.2 times more in Alabama than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

South Dakota· 26th of 51

$2,585

$1,072 physician + $1,514 facility

AL $7,045MT $1,664

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.