CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: HCA Florida Raulerson Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $15,227
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4.56x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at HCA Florida Raulerson Hospital is $15,227. 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 4.56x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,227

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: $15,227 (456%)

Ins. Median: $15,227 (456% 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 456% of the Medicare baseline (a markup of 356%). 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
Freedom Health	$2,350 - $3,950	70%
Optimum	$2,350 - $4,575	70%
Corvel Corporation	$2,834 - $3,555	85%
Careworks (Rockport)	$2,894 - $3,629	87%
Prime Health	$2,894 - $3,629	87%
Simply Healthcare Plans	$3,792	113%
Molina	$3,950 - $5,211	118%
Health Sun Health Plan	$4,200	126%
Sunshine State Health Plan	$6,625	198%
Avmed	$9,796 - $26,390	293%
Cigna	$11,166 - $30,357	334%
Aetna	$12,530 - $16,947	375%
Oscar	$12,772	382%
Simply Healthcare	$13,422	402%
Blue Cross Blue Shield	$21,742 - $24,677	650%
Humana	$27,777	831%
United	$28,000	838%

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 HCA Florida Raulerson 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.