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North Carolina rates for HCPCS 23616

Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement

Facilitymedian $1,995 · 10th–90th $1,202–$10,7150%10%10th90th$1,995Professionalmedian $2,512 · 10th–90th $2,512–$2,8180%20%40%90th$2,512$1.0K$2.0K$5.0K$10.0K$20.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,949.84 / $10,471.29
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $5,370.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $25,703.96
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,818.38
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,698.24 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $15,488.17 / $23,442.29
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33,884.42 / $75,857.76 / $75,857.76
Wellcare
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$7,585.78 / $7,585.78 / $7,585.78