CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Rush Memorial Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $640
Cash Discount Price: $1,335
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Rush Memorial Hospital is $640. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,335. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.19x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$1,335

Average discount available for prompt cash payment at this facility.

Insurance Median

$640

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: $1,335 (40%)

Insurance Median: $640 (19%)

Cash: $1,335 (40% of Medicare)

Ins. Median: $640 (19% 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
UnitedHealthcare	$412 - $474	12%
Caresource Mcr Adv	$474	14%
Aetna	$479 - $505	14%
Humana	$479 - $494	14%
Blue Cross Blue Shield	$488 - $792	15%
Today'S Option Mcr Adv-All Plans	$488	15%
Viant Beech St Mcr Adv	$488	15%
My True Advantage - All Plans	$498	15%
Consumers Life Ins-All Plans	$505	15%
Caresource Marketplace-All Other Plans	$640	19%
Multiplan-All Plans	$840	25%
Phcs-All Plans	$849	25%
Cigna	$890	27%
Health Net	$890	27%
Encore Health Services-All Plans	$915	27%
Siho-All Plans	$915	27%
Coventry/First Health-All Plans	$1,246	37%

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 $1,335.
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 Rush Memorial 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.