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Open Biopsy Of The Main Shoulder Joint

Wisconsin 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 July 2026.

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

$8,633

Typical total for the visit. In Wisconsin, July 2026.

Insurers have agreed to pay about $8,633 for this procedure. That total is two separate charges: $1,047 to the doctor who performs it, and $7,586 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 11 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,047$617 to $1,778
Facility feeThe hospital or surgery center$7,586$5,012 to $8,913

How much rates vary

Facilitymedian $7,586 · 10th to 90th $1,047 to $11,482Professionalmedian $1,047 · 10th to 90th $501 to $2,399
$50$200$1K$5Kfacility $7,586professional $1,047

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,047.13
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$524.81
Typical High
$2,089.30
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$7,943.28
Typical High
$13,182.57
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$1,023.29
Typical High
$2,691.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,584.89
Typical High
$2,754.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$2,089.30
Typical High
$2,344.23
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,047.13
Typical High
$4,168.69
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,230.27
Typical High
$1,584.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,047.13
Typical High
$8,317.64
Medica
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$933.25
Typical High
$3,801.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$5,754.40
Typical High
$7,762.47
Network Health
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$1,174.90
Typical High
$2,089.30
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$691.83
Typical High
$1,174.90
Quartz
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,174.90
Typical High
$1,737.80
Quartz
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$6,456.54
Typical High
$9,332.54
Quartz
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$2,398.83
Typical High
$3,715.35
Security Health
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Security Health
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$2,818.38
Typical High
$3,235.94
United
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$7,413.10
Typical High
$8,709.64
United
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$776.25
Typical High
$2,089.30

Where Wisconsin sits

The same service costs 9.6 times more in Indiana than in West Virginia. 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

Wisconsin· 2nd of 50

$8,633

$1,047 physician + $7,586 facility

IN $9,857WV $1,027

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.