CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Southwest Memorial Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $15,847
  • Cash Discount Price: $8,475
  • vs. Medicare Baseline: 4.74x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Southwest Memorial Hospital is $15,847. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,475. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 4.74x the Medicare baseline. Located in 1311 N Mildred Rd, Cortez, CO.
Cash / Self-Pay
$8,475

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,847

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: $8,475 (254%)
Insurance Median: $15,847 (474%)
Cash: $8,475 (254% of Medicare)
Ins. Median: $15,847 (474% 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 474% of the Medicare baseline (a markup of 374%). 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.

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 Cross Blue Shield $4,915 - $14,915 147%
Humana $4,915 - $16,102 147%
Rocky Mountain Health Maintenance Organization Inc. $15,593 466%
Aetna $15,847 474%
Cigna $15,847 474%
Cofinity $15,847 474%
Great West $15,932 477%
Kaiser Permanente $16,102 482%
Coventry $16,271 487%
UnitedHealthcare $16,271 487%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1311 N Mildred Rd, Cortez, CO 81321
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals