A broken arm can be a major source of financial stress, especially without health coverage. Costs start at a few thousand dollars for a simple break and potentially escalate into the tens of thousands for complex cases. The ultimate cost is determined by the severity of the bone damage and the specific medical facility chosen for treatment. Navigating the costs of diagnosis, stabilization, definitive treatment, and recovery becomes a complex calculation.
Immediate Costs of Diagnosis and Stabilization
Immediate costs begin with diagnosis and stabilization. An initial visit to an Emergency Room (ER) often carries a hefty facility fee, which can range from $1,000 to over $3,000 for the uninsured. Conversely, seeking initial care at an urgent care center for a presumed simple fracture is significantly more cost-effective, with assessment fees typically falling between $100 and $250.
Regardless of the location, X-ray imaging is necessary to confirm the fracture type and location, incurring separate radiology fees. An uninsured X-ray can cost anywhere from $100 to $1,000, with hospital-based imaging being at the higher end of the range. Once the diagnosis is confirmed, the medical provider performs initial stabilization, which involves applying a temporary splint or a partial cast to prevent further injury. The total expense for this initial phase, including the visit, imaging, and stabilization, often totals $2,500 or more before any definitive treatment begins.
Non-Surgical Versus Surgical Treatment Pricing
For a simple, non-displaced fracture, non-surgical treatment involves a procedure called closed reduction, where the orthopedic specialist manually manipulates the bone back into alignment without an incision. This procedure, followed by the application of a final fiberglass or plaster cast, can cost an uninsured patient approximately $2,500 to $3,000, depending on the complexity and facility charges.
More severe, unstable, or comminuted fractures require surgical intervention, such as Open Reduction Internal Fixation (ORIF). An ORIF procedure involves opening the skin to realign the bone fragments and securing them with specialized hardware like metal plates, screws, or pins. The total cost for a surgical repair without insurance can easily exceed $16,000, with complex cases costing much more. This expense includes the surgeon’s fee, operating room time, the cost of the hardware itself, and the separate charge for anesthesia services, which can add up to $2,500.
Follow-Up Care and Rehabilitation Expenses
The financial obligation for a broken arm continues long after the cast is applied or the surgery is completed. Follow-up care requires multiple appointments with the orthopedic specialist to monitor healing progress and ensure the bone is mending correctly. Each of these visits typically includes a new set of X-rays to check alignment and bone density, which means recurring imaging fees of $100 to $1,000 each time.
Once the cast is removed, physical or occupational therapy (PT/OT) is almost always necessary to regain full strength and range of motion. Patients can expect to pay $75 to $150 per therapy session, with the initial evaluation costing up to $400. A typical recovery plan requires two to three sessions per week for six to eight weeks, accumulating a total rehabilitation cost that can reach $4,800 or more. Additional costs for durable medical equipment (DME), such as specialized slings or braces used during recovery, further contribute to the final expense.
How Insurance Impacts Your Final Bill
For those with health insurance, the financial impact of a broken arm is determined by the policy’s specific cost-sharing mechanisms. The patient must first satisfy their annual deductible, which is the amount paid out-of-pocket before the insurance company begins to contribute significantly. For many services, a fixed co-pay is also owed at the time of the visit, regardless of whether the deductible has been met.
Once the deductible threshold is crossed, co-insurance kicks in, requiring the patient to pay a set percentage of the remaining bill, commonly 20%, while the insurer covers the rest. Co-insurance continues until the patient reaches their out-of-pocket maximum, the annual limit on what the individual must pay for covered services. A high-cost surgical procedure will likely cause the patient to quickly meet this maximum, capping their total expense, while a simple non-surgical treatment may only involve the deductible and co-pays. Uninsured patients, however, are charged the full, undiscounted list price for every service, and they must also be wary of balance billing if an out-of-network provider, like an anesthesiologist, was involved.