CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Decatur County Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $1,126
Cash Discount Price: $1,248
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Decatur County Hospital is $1,126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,248. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.34x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.

Cash / Self-Pay

$1,248

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,126

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: $1,248 (37%)

Insurance Median: $1,126 (34%)

Cash: $1,248 (37% of Medicare)

Ins. Median: $1,126 (34% 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	14%
Tricare	$467	14%
UnitedHealthcare	$467 - $1,326	14%
Amerigroup Mcaid-All Plans	$490	15%
Everystep Hospice-All Plans	$811	24%
Wellmark Hmo	$971	29%
Wellmark Ppo - All Other Plans	$971	29%
Midlands Choice-All Plans	$1,126	34%
Misc Commercial-All Plans	$1,139	34%
Rural Carrier Benefit Plan-All Plans	$1,201	36%
Christian Healthcare -All Plans	$1,248	37%
Ntca The Rural Broadband-All Plans	$1,326	40%
Farm Bureau Financial-All Other Plans	$1,404	42%
Farm Bureau Property And Ca	$1,404	42%
Priority Health-All Plans	$1,560	47%
Iowa Total Care Mcaid-All Plans	$1,591	48%

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 $1,248.
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 Decatur County 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.