CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Santa Rosa Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $3,530
Cash Discount Price: $8,009
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Santa Rosa Medical Center is $3,530. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,009. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.06x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.

Cash / Self-Pay

$8,009

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,530

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: $8,009 (240%)

Insurance Median: $3,530 (106%)

Cash: $8,009 (240% of Medicare)

Ins. Median: $3,530 (106% 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
Veterans Eval Services	$543	16%
Medicaid / KanCare	$1,380 - $1,601	41%
Humana	$1,422 - $3,362	43%
Wellcare	$1,449	43%
Molina	$1,560	47%
Fl Community Care	$1,587	47%
Tricare	$3,246	97%
Aetna	$3,362 - $29,953	101%
Blue Cross Blue Shield	$3,362 - $26,302	101%
Cigna	$3,362 - $12,066	101%
Medicare (plans)	$3,362	101%
UnitedHealthcare	$3,362 - $10,358	101%
Node Champva	$3,417	102%
Node Va	$3,417	102%
Node Wellcare Mcr Adv	$3,530	106%
Prime Health Work Comp Fl	$3,707	111%
Florida Workers Compensation	$3,822	114%
Geo Group	$4,271	128%
Node Us Dept Of Labor	$4,271	128%
Florida State Auto Insurance	$6,834	204%
Ambetter / Centene	$8,166	244%
Oscar	$10,299	308%
Self Pay	$12,280	367%
Hospice Of Nw Fl	$26,696	799%
Prime Health Services	$42,713	1278%

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 $8,009.
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 Santa Rosa 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.