CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Franciscan Health Mooresville

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $7,647
Cash Discount Price: $7,130
vs. Medicare Baseline: 2.29x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Franciscan Health Mooresville is $7,647. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,130. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.29x the Medicare baseline. Located in 1201 Hadley Rd, Mooresville, IN.

Cash / Self-Pay

$7,130

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,647

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: $7,130 (213%)

Insurance Median: $7,647 (229%)

Cash: $7,130 (213% of Medicare)

Ins. Median: $7,647 (229% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Mdwise [1175]	$2,274	68%
Medicaid / KanCare	$2,274 - $2,728	68%
Managed Health Services [1302]	$2,344	70%
Medicare (plans)	$3,462 - $3,808	104%
Workers Comp [1172]	$6,924	207%
Blue Cross Blue Shield	$8,371 - $14,684	250%
Commercial [2001]	$13,183	394%
Managed Care [2000]	$13,183	394%
Unicare [1150]	$14,684	439%

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 $7,130.
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 Franciscan Health Mooresville 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.