CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Adventist Health St Helena

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $700
Cash Discount Price: $51
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Adventist Health St Helena is $700. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.21x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$700

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: $51 (2%)

Insurance Median: $700 (21%)

Cash: $51 (2% of Medicare)

Ins. Median: $700 (21% 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.

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
Medi-Cal	$65	2%
Phcs-All Plans	$160 - $1,179	5%
Health Management Network-All Plans	$247 - $1,822	7%
Three Rivers-All Plans	$262 - $1,929	8%
Blue Shield Bh Mcr Adv	$583	17%
Blue Shield Mcr Adv	$583	17%
Kaiser Mcr Adv	$583	17%
Tricare	$583	17%
Ah Employee Health Plan - All Plans	$642	19%
Cigna	$666	20%
Interplan-All Plans	$700	21%
Kaiser-All Other Plans	$700	21%
UnitedHealthcare	$711	21%
Western Growers-All Plans	$834	25%
Blue Shield Epn-All Other Plans	$888	27%
Blue Shield Non-Epn	$938	28%
Aetna	$944	28%
Blue Cross Blue Shield	$1,436	43%

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 $51.
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 Adventist Health St Helena 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.