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Shoulder Replacement for a Broken Upper Arm Bone

Illinois rates for HCPCS 23616

Treats a break at the top of the upper arm bone by replacing the broken ball of the shoulder with an artificial one through an open incision. It is chosen when the bone is in too many pieces, or its blood supply is too damaged, for a repair to be expected to heal. Tendons and bone fragments around the shoulder are reattached to the implant where possible.

Rates data updated July 2026.

Facilitymedian $3,236 · 10th–90th $1,259$16,5960%5%10th90th$3,236Professionalmedian $2,188 · 10th–90th $1,349$6,6070%10%10th90th$2,188$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$2,630.27
Typical High
$8,912.51
BCBS
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$25,118.86
Typical High
$31,622.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$27,542.29
Median
$27,542.29
Typical High
$27,542.29
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$2,187.76
Typical High
$6,606.93
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$8,912.51
Typical High
$16,982.44