CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Madison County Health Care System

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $3,028
  • Cash Discount Price: $3,396
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Madison County Health Care System is $3,028. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,396. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.91x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$3,396

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,028

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: $3,396 (102%)
Insurance Median: $3,028 (91%)
Cash: $3,396 (102% of Medicare)
Ins. Median: $3,028 (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.

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
Aetna $467 - $4,578 14%
Choicecare-All Plans $467 - $6,691 14%
Medical Associates Hp - All Plans $467 - $3,028 14%
Medigold-All Plans $467 - $3,028 14%
Medimore Employee Hp - All Plans $467 - $6,902 14%
Tricare $467 - $3,028 14%
UnitedHealthcare $467 - $6,339 14%
American Hp Mcr Adv-All Plans $490 - $3,180 15%
Madison County Sheriff-All Plans $723 - $3,522 22%
Oscar - All Plans $808 - $4,543 24%
Blue Cross Blue Shield $934 - $5,358 28%
Midlands Choice - All Plans $1,162 - $6,902 35%
Corvel Wc-All Plans $1,301 - $6,339 39%
First Choice-All Plans $1,374 - $6,691 41%
First Health-All Plans $1,374 - $6,691 41%
Integrated Hp-All Plans $1,374 - $6,691 41%
Mutual Of Omaha-All Plans $1,374 - $6,691 41%
Plaines Health-All Plans $1,374 - $6,691 41%
Preferred Hlth Ntwork-All Plans $1,374 - $6,691 41%
Principal Healthcare-All Plans $1,374 - $6,691 41%
Usa Managed Care-All Plans $1,374 - $6,691 41%
Benefit Admin Of America-All Plans $1,446 - $7,043 43%
Iowa Total Care Mcaid-All Plans $1,446 - $3,310 43%
Molina Mcaid/Chip -All Plans $1,482 - $3,426 44%
Amerigroup Mcaid-All Plans $1,533 - $3,509 46%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals