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Minnesota 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
$80.40 / $80.40 / $80.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $67.67 / $738.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$197.83 / $280.69 / $675.24
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$9.47 / $9.47 / $9.47
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.85 / $256.62 / $531.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.44 / $139.72 / $243.90
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$15.19 / $15.19 / $15.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.00 / $1,727.00 / $2,883.00