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Shoulder, Elbow or Forearm Procedures (without CC/MCC)

Pennsylvania rates for MS-DRG 512

Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures without CC/MCC

Rates data updated July 2026.

How much does Shoulder, Elbow or Forearm Procedures (without CC/MCC) cost?

$25,119

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $25,119 for this service. Most negotiated rates run $16,982 to $30,903.

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 9 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $25,119 · 10th to 90th $14,125 to $34,674
$5K$10K$20K$50Kfacility $25,119

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$14,791.08
Median
$25,118.86
Typical High
$34,673.69
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$14,454.40
Median
$26,302.68
Typical High
$41,686.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13,803.84
Median
$26,302.68
Typical High
$40,738.03
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$29,512.09
Median
$29,512.09
Typical High
$35,481.34
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$12,302.69
Median
$27,542.29
Typical High
$33,884.42
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$8,128.31
Median
$30,199.52
Typical High
$47,863.01
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$14,791.08
Median
$24,547.09
Typical High
$34,673.69
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$14,125.38
Median
$18,620.87
Typical High
$28,840.32
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$21,379.62
Typical High
$38,904.51

Where Pennsylvania sits

The same service costs 3.2 times more in New York than in New Mexico. 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.

Pennsylvania· 27th of 51

$25,119

NY $42,658NM $13,183

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.