CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Boone County Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $887
Cash Discount Price: $1,129
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Boone County Hospital is $887. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,129. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.27x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$1,129

Average discount available for prompt cash payment at this facility.

Insurance Median

$887

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: $1,129 (34%)

Insurance Median: $887 (27%)

Cash: $1,129 (34% of Medicare)

Ins. Median: $887 (27% 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
Choice Care Mcr Adv - All Plans	$467 - $626	14%
Humana	$467 - $1,373	14%
Iowa Hlth Adv - All Plans	$467 - $626	14%
Mt Carmel Hp - All Plans	$467 - $626	14%
Va Ccn-All Plans	$467 - $626	14%
Amerigroup Mcr Adv - All Other Plans	$472 - $632	14%
Aetna	$476 - $1,190	14%
UnitedHealthcare	$507 - $896	15%
Tricare	$519 - $3,343	16%
Healthsmart Accell Network	$537 - $1,068	16%
Health Alliance-All Plans	$561 - $1,373	17%
Healthsmart Ppo - All Other Plans	$561 - $1,221	17%
Meridian Mcaid - All Plans	$687 - $1,526	21%
Iowa Total Care Mcaid - All Plans	$700 - $1,557	21%
Medicaid / KanCare	$707 - $1,572	21%
Medical Associates Hp-All Plans	$887 - $1,144	27%
Wellmark Hmo	$1,040 - $4,643	31%
Health Partners Profee Only - All Plans	$1,103	33%
Midlands Choice-All Plans	$1,164 - $1,404	35%
Wellmark Ppo - All Other Plans	$1,221 - $5,098	37%
Mutually Preferred-All Plans	$1,232 - $1,450	37%

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 $1,129.
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 Boone 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.