CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Audubon County Memorial Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $4,912
Cash Discount Price: $4,140
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Audubon County Memorial Hospital is $4,912. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,140. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.47x the Medicare baseline. Located in 515 Pacific Avenue, Audubon, IA.

Cash / Self-Pay

$4,140

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,912

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: $4,140 (124%)

Insurance Median: $4,912 (147%)

Cash: $4,140 (124% of Medicare)

Ins. Median: $4,912 (147% 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
Aetna	$467 - $6,210	14%
Tricare	$467 - $4,968	14%
UnitedHealthcare	$817 - $5,865	24%
Wellmark Hmo	$1,038 - $4,856	31%
Wellmark Ppo - All Other Plans	$1,221 - $5,349	37%
Molina Mcaid - All Plans	$1,380 - $6,900	41%
Iowa Total Care Mcaid - All Plans	$1,394 - $6,969	42%
Amerigroup Mcaid - All Plans	$1,449 - $7,245	43%
Midlands Choice - All Plans	$6,762	202%

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 $4,140.
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 Audubon County Memorial 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.