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New York 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?

$1,175

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $1,175 for this service. The price depends on where it is billed: about $1,000 from a physician practice, and about $4,467 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 5 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$1,000$813 to $1,318
FacilityA hospital or hospital-owned outpatient department$4,467$2,630 to $7,413

How much rates vary

Facilitymedian $4,467 · 10th to 90th $1,230 to $10,965Professionalmedian $1,000 · 10th to 90th $813 to $1,585
$1K$2K$5K$10K$20Kfacility $4,467professional $1,000

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
$5,128.61
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,318.26
Typical High
$2,137.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$50,118.72
Median
$53,703.18
Typical High
$75,857.76
United
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$4,073.80
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$64.57
Typical High
$38,018.94

Where New York 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.

New York· 2nd of 51

$1,175

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.