CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Marion Communtiy Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $9,824
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Marion Communtiy Hospital is $9,824. 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 2.94x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,824

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: $9,824 (294%)

Ins. Median: $9,824 (294% 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 294% of the Medicare baseline (a markup of 194%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Corvel Corporation	$2,873 - $3,603	86%
Prime Health	$2,933 - $3,679	88%
Careworks (Rockport Community)	$3,024 - $3,792	90%
Marion County Schools	$3,024 - $3,792	90%
Molina Healthcare	$3,950 - $6,243	118%
Simply	$3,950	118%
Sunshine State Health Plan	$6,641	199%
Simply Healthcare	$7,432	222%
Aetna	$7,519 - $9,824	225%
Evolutions Healthcare	$8,581	257%
Evolutions	$9,010	270%
Avmed	$10,557 - $23,005	316%
United	$11,168	334%
Ultimate Health Plan	$12,500	374%
Blue Cross Blue Shield	$13,437 - $27,429	402%
Humana	$16,840	504%
Cigna	$22,585 - $54,020	676%

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 Marion Communtiy 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.