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Knee Intercondylar Fracture Treatment, Closed

Montana 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?

$1,505

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

Insurers have agreed to pay about $1,505 for this procedure. That total is two separate charges: $692 to the doctor who performs it, and $813 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$692$603 to $813
Facility feeThe hospital or surgery center$813$741 to $851

How much rates vary

Facilitymedian $813 · 10th to 90th $603 to $891Professionalmedian $692 · 10th to 90th $447 to $955
$100.0$200.0$500.0$1.0K$2.0Kfacility $813professional $692

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
Professional
Modifier
Global
Typical Low
$436.52
Median
$645.65
Typical High
$2,570.40
BCBS
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$794.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$630.96
Typical High
$794.33
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$812.83
Typical High
$891.25
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$812.83
Typical High
$891.25
Providence
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$630.96
Typical High
$933.25
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$660.69
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$741.31
Typical High
$912.01

Where Montana 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 feeMontana $1,505 · 36th 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.