CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: The Children's Hospital of Alabama

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $12,856
Cash Discount Price: $5,528
vs. Medicare Baseline: 3.85x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at The Children's Hospital of Alabama is $12,856. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,528. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 3.85x the Medicare baseline. Located in 1600 Seventh Avenue South, Birmingham, AL.

Cash / Self-Pay

$5,528

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,856

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3,342.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3,342.87 (100%)

Cash / Self-Pay: $5,528 (165%)

Insurance Median: $12,856 (385%)

Cash: $5,528 (165% of Medicare)

Ins. Median: $12,856 (385% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3,342.87 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 385% of the Medicare baseline (a markup of 285%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Tricare	$1,383	41%
Aetna	$12,856	385%
Behavioral Hlth Sys [100258]	$12,856	385%
Cigna	$12,856	385%
Claritev [100309]	$12,856	385%
UnitedHealthcare	$12,856	385%
Viva [100269]	$12,856	385%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $5,528.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 29881.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Hospital of Alabama is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 29881.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.