CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Providence Holy Cross Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $5,473
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Providence Holy Cross Medical Center is $5,473. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.64x the Medicare baseline. Located in 15031 Rinaldi St, Mission Hills, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,473

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%)

Insurance Median: $5,473 (164%)

Ins. Median: $5,473 (164% 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
Blue Shield	$2,160 - $6,083	65%
Aetna	$4,208	126%
Humana	$4,293	128%
Blue Cross Blue Shield	$4,409 - $5,789	132%
Central Health Plan	$4,629	138%
Cigna	$4,893	146%
La Care Health Plan	$5,471	164%
Multiplan	$7,309	219%
Healthnet	$7,332 - $11,827	219%
UnitedHealthcare	$7,629 - $8,674	228%

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 $X.
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 Providence Holy Cross 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.