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Michigan rates for HCPCS G0289

Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.87 / $4,933.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$411.60 / $483.09 / $654.52
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.87 / $91.73 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $1,418.00 / $2,029.00