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Illinois rates for HCPCS G0428

Collagen meniscus implant procedure for filling meniscal defects (e.g., CMI, collagen scaffold, Menaflex)

Rates data updated July 2026.

How much does HCPCS G0428 cost?

$813

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $813 for this service. The price depends on where it is billed: about $813 from a physician practice, and about $1,905 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$813$813 to $813
FacilityA hospital or hospital-owned outpatient department$1,905$1,148 to $5,129

How much rates vary

Facilitymedian $1,905 · 10th to 90th $813 to $7,762Professionalmedian $813 · 10th to 90th $151 to $813
$100$200$500$1K$2K$5K$10Kfacility $1,905professional $813

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$1,862.09
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$123.03
Typical High
$190.55
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$147.91
Typical High
$158.49
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$1,513.56
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$2,951.21
Typical High
$7,413.10

Where Illinois sits

The same service costs 19.5 times more in California than in Ohio. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 33rd of 51

$813

CA $3,802OH $195

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.