CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Saint Agnes Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $4,840
Cash Discount Price: $17,405
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Saint Agnes Medical Center is $4,840. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,405. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.45x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.

Cash / Self-Pay

$17,405

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,840

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: $17,405 (521%)

Insurance Median: $4,840 (145%)

Cash: $17,405 (521% of Medicare)

Ins. Median: $4,840 (145% 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 Healthnet	$118	4%
Aetna	$4,124	123%
Blue Cross Blue Shield	$4,124 - $8,726	123%
Humana	$4,124 - $4,335	123%
UnitedHealthcare	$4,207 - $10,457	126%
Medicare (plans)	$4,296 - $4,335	129%
Welbe Health	$4,330	130%
Blue Shield - Ca	$4,667 - $7,115	140%
Align Senior Care	$4,840	145%
Blue Benefit Administrators Of Massachusetts	$7,115	213%
Blue Care Network	$7,115	213%
Blue Distinction Transplant	$7,115	213%
Blue Shield - Id (Regence)	$7,115	213%
Blue Shield - Ny Highmark Northeastern	$7,115	213%
Blue Shield - Ny Highmark Western	$7,115	213%
Blue Shield - Pa (Highmark)	$7,115	213%
Blue Shield - Wa (Regence)	$7,115	213%
Kaiser Permanente	$7,365	220%
Advantek Central Usd	$8,726	261%
Healthnet	$10,451	313%
Geha	$10,457	313%

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 $17,405.
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 Saint Agnes Medical Center 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.