CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: HSHS St Elizabeth's Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $6,244
  • Cash Discount Price: $5,598
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at HSHS St Elizabeth's Hospital is $6,244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,598. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.87x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$5,598

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,244

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: $5,598 (167%)
Insurance Median: $6,244 (187%)
Cash: $5,598 (167% of Medicare)
Ins. Median: $6,244 (187% 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
Molina Healthcare $1,948 - $3,792 58%
Meridian Health Plan $2,040 - $3,061 61%
Amish Community $2,177 65%
Aetna $3,622 - $5,474 108%
Blue Cross Blue Shield $3,622 - $7,776 108%
Clear Spring Health Of Illinois $3,622 108%
Health Alliance Medical Plans $3,622 - $6,609 108%
Health Partners $3,622 108%
Humana $3,622 108%
Sae Hospice $3,622 108%
UnitedHealthcare $3,622 - $7,776 108%
Wellfirst $5,007 150%
First Health $5,785 173%
Cigna $6,143 - $7,776 184%
Healthlink $6,182 - $7,776 185%
Caterpillar, Inc. $6,244 187%
Consociate Group $6,843 205%
Choicecare $6,998 209%
Healthcare Finest Network (Hfn) $6,998 209%
Multiplan/Phcs $6,998 209%
Provider Network Of America $6,998 209%
Celtic Insurance Company $7,238 217%
City Of Springfield $7,776 233%
Claim Doc $7,776 233%
Current Health Solutions $7,776 233%
Healthscope $7,776 233%
Hopetrust $7,776 233%
Illinois Breast And Cervical Cancer Program $7,776 233%
Interplan $7,776 233%
Live360 $7,776 233%
Wexford $7,776 233%
Naphcare $7,850 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals