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Pennsylvania 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 $5,370 · 10th–90th $1,288–$8,5110%10%10th90th$5,370$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $5,370.32 / $8,511.38
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,125.38 / $14,125.38 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34,673.69 / $34,673.69 / $34,673.69
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $4,265.80 / $8,511.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $6,309.57 / $56,234.13