CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Fayette County Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $562
Cash Discount Price: $2,180
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Fayette County Hospital is $562. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,180. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.17x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$2,180

Average discount available for prompt cash payment at this facility.

Insurance Median

$562

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: $2,180 (65%)

Insurance Median: $562 (17%)

Cash: $2,180 (65% of Medicare)

Ins. Median: $562 (17% 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	$351 - $730	10%
Blue Cross Blue Shield	$351 - $1,110	10%
Illinicare - All Plans	$351	10%
Medicaid / KanCare	$351	10%
Meridian-All Plans	$351	10%
Health Alliance Mcare	$521	16%
Healthlink Mcr Adv	$521	16%
Cigna	$603	18%
Coventry/Ghp-All Plans	$730	22%
Multiplan - All Plans	$964	29%
Health Alliance - All Other Plans	$1,042	31%
UnitedHealthcare	$1,809	54%
Healthlink Hmo	$1,875	56%
Healthlink Ppo - All Other Plans	$1,875	56%

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 $2,180.
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 Fayette 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.