Hospital, regional, and policy-level variations in shoulder arthroplasty prices: a Nationwide database study

Shoulder arthroplasty negotiated payor rates show large variations and are associated with several factors, including hospital size, payor class, and regional factors. Mean TSA rates were $68 higher, a clinically insignificant amount. States with CON laws and APCD database participation have lower payor rates while states with Medicaid expansion have higher rates. These findings underscore significant variations in how hospitals and payors negotiate rates for shoulder arthroplasty, emphasizing the many factors that play a role in shaping surgical costs.