CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Northwest Health - Porter

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $5,539
  • Cash Discount Price: $19,688
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Northwest Health - Porter is $5,539. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,688. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.66x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$19,688

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,539

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: $19,688 (589%)
Insurance Median: $5,539 (166%)
Cash: $19,688 (589% of Medicare)
Ins. Median: $5,539 (166% 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
One Call $474 14%
Veterans Eval Services $494 15%
Aetna $1,030 - $35,219 31%
Blue Cross Blue Shield $2,274 - $14,109 68%
Caresource $2,274 68%
Humana $2,274 - $3,406 68%
Managed Health Services $2,274 - $6,924 68%
Medicaid / KanCare $2,274 68%
Mhs $2,274 68%
UnitedHealthcare $2,274 - $4,105 68%
Medicare (plans) $3,406 - $3,635 102%
Node Mhs Mcr Adv $3,406 102%
Healthy Indiana Plan $3,462 104%
Node Hospice Non Par Agree $3,462 104%
Node Va $3,462 104%
Node Devoted Health Mcr Adv $3,474 104%
Care Improvement Plus $3,577 107%
In Dept Of Correction $3,600 108%
Node Us Dept Of Labor $4,327 129%
Align Network $5,539 166%
One Call Work Comp $5,539 166%
Encore Health $6,231 - $58,334 186%
Prime Health $6,231 - $54,688 186%
Indiana Work Comp $6,924 207%
Lutheran Preferred $6,924 - $43,751 207%
Tricare $8,170 244%
Node Encore Kba Epo $8,308 249%
Porter County $8,308 249%
Preferred Network Access $8,308 249%
Magnacare Ma $8,817 264%
Lutheran Preferred Chs Employees $17,500 524%
Self Pay $19,688 589%
Cigna $20,271 606%
Physicians Health Plan $27,942 836%
Php Freedom $30,122 901%
Sagamore Health Network $32,230 - $43,167 964%
First Health Coventry $35,730 1069%
Encore Ppo $36,459 1091%
Southeastem Indiana Health Operations $51,043 - $54,688 1527%
Network Synergy Group $54,688 1636%
Multiplan/Phcs $61,251 1832%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals