CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Ottumwa Regional Health Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $3,038
Cash Discount Price: $5,187
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Ottumwa Regional Health Center is $3,038. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,187. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.91x the Medicare baseline. Located in 1001 E Pennsylvania, Ottumwa, IA.

Cash / Self-Pay

$5,187

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,038

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: $5,187 (155%)

Insurance Median: $3,038 (91%)

Cash: $5,187 (155% of Medicare)

Ins. Median: $3,038 (91% 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
Iowa Total Care Inc	$2,933	88%
Wellpoint Iowa, Inc.	$3,023	90%
UnitedHealthcare	$3,038	91%
Wellmark Health Plan Of Iowa	$4,856	145%
Blue Cross Blue Shield	$5,349	160%

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 $5,187.
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 Ottumwa Regional Health 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.