CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: St Luke's Wood River Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $6,396
Cash Discount Price: $7,625
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at St Luke's Wood River Medical Center is $6,396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,625. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.91x the Medicare baseline. Located in 100 Hospital Drive, Ketchum, ID.

Cash / Self-Pay

$7,625

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,396

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: $7,625 (228%)

Insurance Median: $6,396 (191%)

Cash: $7,625 (228% of Medicare)

Ins. Median: $6,396 (191% 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
Commercial [1028]	$3,920 - $8,121	117%
Medicare (plans)	$3,920 - $4,867	117%
Veterans Affairs [1056]	$3,920 - $4,772	117%
Blue Cross Blue Shield	$3,959 - $7,158	118%
UnitedHealthcare	$4,116 - $7,577	123%
Aetna	$4,312 - $7,953	129%
Moda [1055]	$6,052 - $7,367	181%
Geha [1065]	$6,224 - $7,577	186%
United Medical Resources [1051]	$6,224 - $7,577	186%
Cigna	$6,396 - $7,786	191%
Providence [1022]	$6,396 - $7,786	191%
First Health [1064]	$6,533 - $8,121	195%
Webtpa [1071]	$6,533 - $7,953	195%
Pacificsource [1020]	$7,870	235%

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 $7,625.
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 St Luke's Wood River Medical 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.