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Shoulder Replacement for a Broken Upper Arm Bone

North Carolina 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.

How much does Shoulder Replacement for a Broken Upper Arm Bone cost?

$1,950

Typical facility fee. In North Carolina, July 2026.

Insurers have agreed to pay about $1,950 for this service. Most negotiated rates run $1,413 to $7,079.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,950 · 10th to 90th $1,202 to $10,471Professionalmedian $2,512 · 10th to 90th $2,512 to $2,818
$1K$2K$5K$10K$20K$50Kfacility $1,950professional $2,512

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. 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
Global
Typical Low
$1,202.26
Median
$1,949.84
Typical High
$10,471.29
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,949.84
Typical High
$25,703.96
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$2,818.38
Medcost
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,698.24
Typical High
$2,884.03
United
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$14,791.08
Typical High
$26,915.35
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$33,884.42
Median
$75,857.76
Typical High
$75,857.76
Wellcare
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$7,585.78
Median
$7,585.78
Typical High
$7,585.78

Where North Carolina sits

The same service costs 31.6 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.

North Carolina· 46th of 50

$1,950

IN $38,905WV $1,230

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.