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Pennsylvania rates for HCPCS 27538

Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation

Facilitymedian $2,692 · 10th–90th $589–$8,3180%5%10%10th90th$2,692Professionalmedian $490 · 10th–90th $417–$9550%20%40%10th90th$490$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $478.63 / $954.99
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $512.86 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $549.54 / $933.25
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $870.96 / $1,122.02
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $660.69 / $933.25
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $524.81 / $588.84
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,905.46 / $6,606.93
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $489.78 / $1,000.00
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $741.31 / $1,096.48
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $446.68 / $478.63
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $457.09 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $676.08 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $524.81 / $912.01