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Virginia 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 $3,631 · 10th–90th $1,288–$12,8820%5%10%10th90th$3,631Professionalmedian $1,585 · 10th–90th $1,072–$2,5120%10%20%10th90th$1,585$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
$1,380.38 / $5,495.41 / $10,000.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,882.50 / $22,387.21 / $38,018.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,348.96 / $1,621.81
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,511.89 / $2,818.38
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,621.81 / $2,511.89
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,659.59 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $11,748.98 / $26,302.68