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Knee Arthroscopy, Body Removal or Chondroplasty

Utah 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

Rates data updated July 2026.

Facilitymedian $3,388 · 10th–90th $112$6,0260%20%10th90th$3,388Professionalmedian $126 · 10th–90th $91$1620%20%10th90th$126$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$3,388.44
Typical High
$6,025.60
Select Health
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$125.89
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$4,466.84
Typical High
$5,128.61