CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Pulaski Memorial Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $494
Cash Discount Price: $741
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Pulaski Memorial Hospital is $494. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $741. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.15x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$741

Average discount available for prompt cash payment at this facility.

Insurance Median

$494

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: $741 (22%)

Insurance Median: $494 (15%)

Cash: $741 (22% of Medicare)

Ins. Median: $494 (15% 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	$469 - $494	14%
Ambetter / Centene	$474	14%
Blue Cross Blue Shield	$474 - $835	14%
Caresource Mcaid Hip	$474	14%
Caresource Mcare Hmo	$474	14%
Cenpatico Mcaid Hip	$474	14%
Humana	$474 - $640	14%
Mhs Mcaid Hip	$474	14%
Mhs Mcare Allwell	$474	14%
Multiplan - All Plans	$474	14%
Caresource Mcaid Hhw	$494	15%
Cenpatico Mcaid Hhw - All Other Plans	$494	15%
Mhs Mcaid Hhw/Hcc	$494	15%
Mdwise Mcaid Hcc	$496	15%
Mdwise Mcaid Hhw	$496	15%
Mdwise Mcaid Hip - All Other Plans	$496	15%
Caresource Exch Hmo Hix - All Other Plans	$593	18%
Encore Ppo - All Other Plans	$640	19%
Cigna	$835	25%
Sagamore - All Other Plans	$835	25%
Sagamore Rose Acre	$835	25%
Encore Workers Comp	$953	29%
Community Health Alliance - All Plans	$1,087	33%

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 $741.
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 Pulaski 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.