Shoulder arthroscopy Cost by Hospital

Shoulder arthroscopy is a surgical procedure. Prices are from 1511 US hospitals across 52 states, from their machine-readable files.

$5,848median cash price · 1511 hospitals, 52 statestypically $1,627–$20,173 depending on the hospital
≈ 6.1× Medicare · High vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$8,426
Cash / self-pay
$5,848
Insurer-negotiated
$7,137
Medicare pays
$962
$1,627$20,173
Median cash $5,848  ·  Medicare $962  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $5,848 — about 6.1× the Medicare rate ($962). High vs Medicare. A fair cash price is usually within ~2× Medicare ($1,925).

💡 Asking for the cash price instead of the $8,426 list price could save about $2,578 (31%).

Estimate what you’ll pay
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Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
Pratt Regional Medical Center Pratt, KS $879 $2,441 ★ 4/5 100 min —
Bassett Healthcare Cooperstown, NY $966 $1,028 ★ 2/5 199 min —
Hospital Pavia Caguas Caguas, PR $1,000 $689 — — —
Livingston Hospital and Healthcare Services, Inc Salem, KY $1,009 $918 ★ 4/5 106 min —
Canton-Potsdam Hospital Potsdam, NY $1,011 $1,016 ★ 2/5 142 min —
Southwestern Vermont Medical Center Bennington, VT $1,041 — ★ 3/5 202 min —
Red Bud Regional Hospital Red Bud, IL $1,064 $1,714 ★ 4/5 122 min —
Ashtabula County Medical Center Ashtabula, OH $1,072 $1,449 ★ 3/5 194 min —
Braxton County Memorial Hospital, Inc Gassaway, WV $1,095 — — 102 min —
St Joseph's Hospital of Buckhannon, Inc Buckhannon, WV $1,095 — ★ 3/5 141 min —
Bayside Community Hospital Anahuac, TX $1,095 $629 — 106 min —
Summersville Regional Medical Center Summersville, WV $1,117 — ★ 2/5 136 min —
Ste Genevieve County Memorial Hospital Sainte Genevieve, MO $1,135 $926 ★ 4/5 103 min —
Cameron Memorial Community Hospital Inc Angola, IN $1,137 $1,094 ★ 3/5 171 min —
San Juan Hospital Monticello, UT $1,146 $1,067 — 128 min —
Potomac Valley Hospital Keyser, WV $1,151 — ★ 1/5 119 min —
Harrison Community Hospital Cadiz, OH $1,163 — — 82 min —
Barnesville Hospital Association, Inc Barnesville, OH $1,163 $4,513 — 115 min —
Kau Hospital Pahala, HI $1,170 — — 79 min —
Hugh Chatham Memorial Hospital Elkin, NC $1,178 $1,166 ★ 3/5 168 min —
Grove Hill Memorial Hospital Grove Hill, AL $1,262 $6,698 — 166 min —
Artesia General Hospital Artesia, NM $1,296 $3,990 — 99 min —
Jackson General Hospital Ripley, WV $1,310 — ★ 3/5 127 min —
Deaconess Hospital Inc Evansville, IN $1,313 $1,309 ★ 2/5 186 min —
The Women's Hospital Newburgh, IN $1,313 $2,715 ★ 5/5 130 min —

CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated October 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.

What insurers pay for Shoulder arthroscopy

Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $5,848; Medicare pays $962.

InsurerHospitalsNegotiated median
Medicaid 147
$398
$66 – $974
Medicare 253
$498
$81 – $7,511
Univera 14
$854
$124 – $1,284
Tricare / VA 170
$1,028
$466 – $8,454
AmeriHealth 129
$1,143
$166 – $13,315
Geisinger 38
$1,146
$229 – $7,527
Independent Health 21
$1,299
$511 – $4,094
Highmark 89
$1,355
$422 – $14,414
MVP Health Care 48
$1,393
$745 – $12,361
Bright Health 36
$1,714
$1,257 – $5,995
Sanford Health Plan 26
$1,919
$778 – $12,650
Priority Health 37
$2,103
$805 – $6,967
Workers' Comp / No-Fault 41
$2,202
$2,169 – $13,155
HealthPartners 100
$2,391
$467 – $11,038
Centene / Ambetter 529
$2,394
$431 – $11,227
Amerigroup 115
$2,518
$721 – $7,254
Molina Healthcare 400
$2,638
$488 – $8,666
UPMC Health Plan 60
$2,971
$867 – $16,739
MultiPlan / PHCS network 214
$3,250
$467 – $11,621
Health Net 134
$3,600
$385 – $16,280
Harvard Pilgrim 24
$3,669
$1,206 – $12,808
Blue Cross Blue Shield 800
$3,741
$431 – $16,920
Medica 62
$4,168
$974 – $10,876
Coventry 54
$4,525
$1,083 – $11,606
SelectHealth 33
$5,307
$1,978 – $12,599
Aetna 881
$6,194
$995 – $13,140
UCare 35
$6,273
$781 – $12,385
Humana 649
$6,543
$945 – $19,987
Anthem 374
$6,720
$480 – $16,686
Cigna 657
$6,849
$1,715 – $22,301
UnitedHealthcare 946
$7,099
$941 – $16,164
Security Health Plan 25
$7,111
$948 – $13,221
Devoted Health 105
$7,124
$6,542 – $7,864
Kaiser Permanente 140
$7,179
$467 – $21,078
Oscar Health 145
$8,970
$3,549 – $14,192
Healthcare Highways 34
$8,991
$8,517 – $9,565
EmblemHealth 51
$12,590
$2,509 – $57,245
AvMed 33
$19,079
$1,497 – $27,374

Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.

Where it’s cheapest

StateMedian cash
Puerto Rico$1,000
New Hampshire$1,626
Vermont$1,631
Michigan$2,524
Arkansas$2,675
Wyoming$2,962

Prices by city

Prices by state

Doctors who perform this

Clinicians who reported the most Medicare volume for this service. This reflects Original Medicare activity only and is a volume signal, not a quality ranking.

ClinicianSpecialtyLocationMedicare services
Calvin Oishi, M.D.Orthopedic SurgeryAiea, HI40
David Higgins, M.D.Orthopedic SurgeryOlney, MD33
David Higgins, M.D.Orthopedic SurgeryOlney, MD33
Kevin Murphy, MDOrthopedic SurgeryJacksonville, FL26
Jon Orjala, D.O.Orthopedic SurgeryOwasso, OK26
Greer Noonburg, MDOrthopedic SurgerySavannah, GA23
Richard Harrison, M.D.Hand SurgeryMelbourne, FL23
David Gotham, DOOrthopedic SurgeryRocklin, CA19
Todd Horton, MDOrthopedic SurgeryKingsport, TN18
Ralph Garretson, MDOrthopedic SurgeryWarrenton, VA16
Andrew Millis, M.D.Orthopedic SurgeryCincinnati, OH14
Danya Julson, D.O.Orthopedic SurgeryTulsa, OK13

Browse doctors by specialty & city →

Does Medicare cover Shoulder arthroscopy?

Yes — Medicare generally covers Shoulder arthroscopy. It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $962. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $192 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.

General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.

About these prices

Based on prices published by 1511 US hospitals across 52 states, the typical (median) cash price is $5,848, versus a chargemaster (list) price around $8,426, a median insurer-negotiated rate of $7,137, a Medicare rate of about $962. Most cash prices fall between $1,627 and $20,173 — a wide spread, which is exactly why comparing hospitals pays off.

How to save

  • Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
  • Compare several nearby hospitals; prices for the same service can differ severalfold.
  • Request a written estimate and the billing code (CPT/DRG) before scheduling.
  • Use the Medicare benchmark above to judge whether a quote is reasonable.
  • If you are uninsured, ask about financial assistance or prompt-pay discounts.

Frequently asked questions

How much does Shoulder arthroscopy cost without insurance?
The median cash (self-pay) price across 1511 US hospitals is $5,848. Most hospitals fall between $1,627 and $20,173. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Shoulder arthroscopy?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $962). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Shoulder arthroscopy?
Medicare pays about $962. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Shoulder arthroscopy prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

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