CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Saint Joseph Regional Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $5,193
  • Cash Discount Price: $18,163
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Saint Joseph Regional Medical Center is $5,193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,163. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.55x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$18,163

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,193

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: $18,163 (543%)
Insurance Median: $5,193 (155%)
Cash: $18,163 (543% of Medicare)
Ins. Median: $5,193 (155% 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
Aetna $1,792 - $5,366 54%
Blue Cross Blue Shield $1,792 - $12,222 54%
Medicaid / KanCare $1,792 - $2,274 54%
UnitedHealthcare $1,792 - $3,460 54%
Managed Health Services - Indiana $2,274 68%
Mdwise $2,274 68%
Medicare (plans) $3,462 - $3,531 104%
Meridian Complete $3,462 104%
Pace-Trinity Health $3,462 104%
County Coroner $3,600 108%
Provider Partners Health Plan Of Indiana $3,808 114%
Auxiant $5,193 - $7,443 155%
Physicians Health Plan Northern Indiana Health Insurance $5,193 - $10,455 155%
St Joseph County Hlth Dpt $5,193 155%
Caresource $5,366 161%
Siho Insurance Services $5,539 166%
Key Benefit Administrator $6,231 - $7,443 186%
Allied Benefit Systems $6,577 197%
Custom Design Benefits $7,443 223%
Blue Benefit Administrators Of Massachusetts $12,222 366%
Blue Care Network $12,222 366%
Blue Distinction Transplant $12,222 366%
Blue Shield - Ca $12,222 366%
Blue Shield - Id (Regence) $12,222 366%
Blue Shield - Ny Highmark Northeastern $12,222 366%
Blue Shield - Ny Highmark Western $12,222 366%
Blue Shield - Pa (Highmark) $12,222 366%
Blue Shield - Wa (Regence) $12,222 366%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals