CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: John Muir Medical Center - Walnut Creek Campus

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $18,129
  • Cash Discount Price: $39,667
  • vs. Medicare Baseline: 5.42x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at John Muir Medical Center - Walnut Creek Campus is $18,129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39,667. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 5.42x the Medicare baseline. Located in 1601 Ygnacio Valley Rd, Walnut Creek, CA.
Cash / Self-Pay
$39,667

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,129

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: $39,667 (1187%)
Insurance Median: $18,129 (542%)
Cash: $39,667 (1187% of Medicare)
Ins. Median: $18,129 (542% 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 542% of the Medicare baseline (a markup of 442%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

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

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Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Contra Costa County Jail [1012104] $551 16%
Jmpn Canopy Hn [1640000011] $736 22%
UnitedHealthcare $736 - $53,372 22%
Donor Network West [1008103] $4,000 120%
Golden State-Network Mcare [1023127] $4,158 - $16,316 124%
Tricare $4,405 - $9,788 132%
Health Net-Network Mcare [1028127] $4,528 - $17,767 135%
Aetna $4,620 - $18,129 138%
Alignment Health [1177113] $4,620 - $18,129 138%
Blue Cross Blue Shield $4,620 - $51,758 138%
Blue Shield-Network Mcare [1006127] $4,620 - $18,129 138%
Care 1St Health Plan [1094113] $4,620 - $18,129 138%
Caremore [1171113] $4,620 - $18,129 138%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $4,620 - $18,129 138%
Easy Choice Health Plan [1083113] $4,620 - $18,129 138%
Essence Healthcare [1049028] $4,620 - $18,129 138%
Essence Healthcare [1049128] $4,620 - $18,129 138%
Hospice Of East Bay [1085104] $4,620 - $18,129 138%
Humana $4,620 - $18,129 138%
Medicare (plans) $4,620 - $18,129 138%
Scan-Network Mcare [1043127] $4,620 - $18,129 138%
Veterans Administration [1051113] $4,620 - $18,129 138%
Workers' Comp [1024005] $5,072 - $11,227 152%
Generic Commercial/Indemnity [1017001] $5,775 - $22,662 173%
Generic Hmo [1018103] $5,775 - $22,662 173%
Generic Ppo [1021104] $5,775 - $22,662 173%
Canopy Hn Hmo [1166103] $8,455 - $33,176 253%
Blue Shield Hmo [1006103] $15,244 - $16,356 456%
Blue Shield-Network [1006026] $15,244 - $16,356 456%
Cigna $16,526 - $21,513 494%
Blue Shield Ppo [1006104] $16,575 - $21,400 496%
Brms [1091104] $27,619 - $51,758 826%
Delta Health Systems [1032104] $27,619 - $51,758 826%
Empire Plan [1092104] $27,619 - $51,758 826%
Healthcomp [1089104] $27,619 - $51,758 826%
United Behavioral Health [1048103] $35,576 - $53,372 1064%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1601 Ygnacio Valley Rd, Walnut Creek, CA 94598
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals