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Total Shoulder Replacement (Open Surgery)

Pennsylvania rates for HCPCS 23472

This surgery replaces both sides of the shoulder joint, the ball at the top of the arm bone and the socket in the shoulder blade, with prosthetic components through an open surgical incision. It's typically performed for advanced shoulder arthritis or joint damage when other treatments have not provided lasting relief. The procedure is a larger reconstructive operation compared to repairs that address only part of the joint or surrounding tissue.

Rates data updated July 2026.

How much does Total Shoulder Replacement (Open Surgery) cost?

$10,133

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

Insurers have agreed to pay about $10,133 for this procedure. That total is two separate charges: $1,622 to the doctor who performs it, and $8,511 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 13 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,622$1,380 to $2,291
Facility feeThe hospital or surgery center$8,511$5,495 to $25,119

How much rates vary

Facilitymedian $8,511 · 10th to 90th $1,660 to $40,738Professionalmedian $1,622 · 10th to 90th $380 to $3,548
$100$1K$10K$100Kfacility $8,511professional $1,622

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
$1,621.81
Median
$8,317.64
Typical High
$40,738.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$1,621.81
Typical High
$3,630.78
Aetna
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$204.17
Median
$457.09
Typical High
$794.33
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,737.80
Typical High
$2,238.72
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$19,054.61
Typical High
$51,286.14
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,819.70
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$21,379.62
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$2,041.74
Typical High
$2,691.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$2,290.87
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,754.23
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,737.80
Typical High
$2,884.03
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$2,089.30
Typical High
$2,691.53
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,778.28
Typical High
$2,884.03
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$9,332.54
Median
$37,153.52
Typical High
$77,624.71
Highmark BCBS
Setting
Facility
Modifier
22 · Increased work
Typical Low
$6,025.60
Median
$15,135.61
Typical High
$81,283.05
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,819.70
Typical High
$2,344.23
Highmark BCBS
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$234.42
Median
$234.42
Typical High
$302.00
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$18,620.87
Typical High
$50,118.72
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$2,089.30
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$9,332.54
Typical High
$46,773.51
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,621.81
Typical High
$3,548.13
Martin's Point
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$204.17
Median
$346.74
Typical High
$794.33
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$1,621.81
Typical High
$1,862.09
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$5,128.61
Typical High
$9,332.54
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,412.54
Typical High
$1,698.24
United
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$9,772.37
Typical High
$51,286.14
United
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,737.80
Typical High
$3,090.30
United
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$457.09
Median
$457.09
Typical High
$457.09

Where Pennsylvania sits

The same service costs 5.0 times more in Maine 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

Pennsylvania· 25th of 50

$10,133

$1,622 physician + $8,511 facility

ME $21,651MT $4,332

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.