CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $848
Cash Discount Price: $1,965
vs. Medicare Baseline: 0.25x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Cleveland Clinic Indian River Hospital is $848. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,965. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.25x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$1,965

Average discount available for prompt cash payment at this facility.

Insurance Median

$848

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: $1,965 (59%)

Insurance Median: $848 (25%)

Cash: $1,965 (59% of Medicare)

Ins. Median: $848 (25% 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
UnitedHealthcare	$404	12%
Amerihealth	$425	13%
Medicaid / KanCare	$425	13%
Molina	$425	13%
Value Options	$425 - $572	13%
Wellcare	$425 - $3,257	13%
Blue Cross Blue Shield	$514 - $5,557	15%
Avmed	$572 - $7,458	17%
Careplus	$572 - $3,257	17%
Magellan	$572	17%
United	$572 - $3,257	17%
Freedom Health	$601 - $3,257	18%
Independent Living Systems	$601 - $3,420	18%
Wellmed	$601 - $3,257	18%
Clear Spring Health	$618	18%
Aetna	$636 - $3,257	19%
Cigna	$751 - $963	22%
Clarity Health	$1,965	59%
The Legacy Companies	$1,965	59%
National Provider Network	$2,116	63%
Three Rivers	$2,116	63%
Consociate Health	$2,267	68%
Carelon Bh Strategies	$3,257	97%
Humana	$3,257	97%
Devoted Health	$3,583	107%

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 $1,965.
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 Cleveland Clinic Indian River Hospital 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.