CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Anderson Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $3,450
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Anderson Hospital is $3,450. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.03x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,450

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%)

Insurance Median: $3,450 (103%)

Ins. Median: $3,450 (103% 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
Humana	$536 - $3,450	16%
Medicare (plans)	$536 - $3,450	16%
UnitedHealthcare	$536 - $3,450	16%
Tricare	$546 - $3,380	16%
Medicaid / KanCare	$1,049 - $2,685	31%
Work Comp	$2,259 - $6,720	68%
Aetna	$3,450	103%
Essence	$3,506 - $3,612	105%
Devoted Health Ppo	$3,519	105%
Clear Springs Health	$3,554	106%
Ambetter / Centene	$5,084	152%
Blue Choice	$5,084	152%
Blue Cross Blue Shield	$6,640	199%
Hopetrust	$8,766	262%
Self Pay	$25,000	748%

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 $X.
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 Anderson 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.