CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Adventist Health Sonora

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $344
Cash Discount Price: $59
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Adventist Health Sonora is $344. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.10x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$344

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: $59 (2%)

Insurance Median: $344 (10%)

Cash: $59 (2% of Medicare)

Ins. Median: $344 (10% 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
Bc Mcal	$95	3%
Celtic Ca Hlth Well Mcal - All Plans	$95	3%
Central Ca Alliance Mcal	$95	3%
Healthnet Mcal	$95	3%
Medi-Cal	$95	3%
Central Ca Alliance Ccs Mcal	$142	4%
Central Ca Alliance Comm Profee Only-All Other Pla	$142	4%
Central Ca Alliance Chdp Mcal	$190	6%
UnitedHealthcare	$224 - $1,648	7%
Beech Street- All Plans	$234 - $1,721	7%
Trpn - Three Rivers Ppo - All Plans	$234 - $1,721	7%
Blue Shield Mcare	$521	16%
Central Ca Alliance Mcr Adv Profee Only	$521	16%
Healthnet Mcr Adv	$521	16%
Tricare	$521	16%
Ah Employee Health Plan - All Plans	$573	17%
Cigna	$641	19%
Greatwest Oa/Pos/Hmo	$677	20%
Greatwest Ppo - All Other Plans	$677	20%
Western Growers/Pinnacle - All Plans	$724	22%
Healthnet - All Other Plans	$759	23%
Blue Shield Epn	$813	24%
Blue Shield - All Other Plans	$859	26%
Aetna	$980	29%
Bc Mcs	$1,305	39%
Bc Non-Mcs - All Other Plans	$1,305	39%

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 $59.
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 Sonora 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.