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Knee Intercondylar Fracture Treatment, Closed

Illinois rates for HCPCS 27538

This treatment addresses a fracture at the top of the shinbone where knee ligaments attach, sometimes called a tibial spine fracture. The break is treated without opening the knee, using a cast, brace, or gentle manipulation of the joint from outside the skin to allow the bone fragment to heal in position. It is most common after a twisting injury to the knee, especially in children and teenagers.

Rates data updated July 2026.

How much does Knee Intercondylar Fracture Treatment, Closed cost?

$1,863

Typical total for the visit. In Illinois, July 2026.

Insurers have agreed to pay about $1,863 for this procedure. That total is two separate charges: $661 to the doctor who performs it, and $1,202 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$661$479 to $891
Facility feeThe hospital or surgery center$1,202$813 to $2,884

How much rates vary

Facilitymedian $1,202 · 10th to 90th $457 to $5,370Professionalmedian $661 · 10th to 90th $417 to $1,072
$50.0$200.0$1.0K$5.0Kfacility $1,202professional $661

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
$501.19
Median
$1,258.93
Typical High
$5,370.32
Aetna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$501.19
Typical High
$1,096.48
BCBS
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$426.58
Typical High
$10,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$758.58
Typical High
$1,071.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$645.65
Typical High
$977.24
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$776.25
Typical High
$1,819.70
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$575.44
Typical High
$691.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$61.66
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$660.69
Typical High
$2,089.30
United
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$562.34
Typical High
$977.24

Where Illinois sits

The same service costs 9.6 times more in New Jersey than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeIllinois $1,863 · 31st of 49
NJ $5,860MD $613

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.