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Montana 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.55 / $133.55 / $133.55
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.56 / $90.15 / $133.55