Knee arthroscopy with meniscus repair
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 29881 (CPT)
- CPT Billing Code: 29881
- Insurance Median: $3,099
- Cash Discount Price: $12,698
- vs. Medicare Baseline: 0.93x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Indian Health Service Contracted [320198] | $483 | 14% |
| Blue Cross Blue Shield | $483 - $4,884 | 14% |
| Medicaid / KanCare | $1,049 - $3,159 | 31% |
| UnitedHealthcare | $2,766 - $3,159 | 83% |
| Humana | $2,889 - $3,099 | 86% |
| Aetna | $2,889 - $3,099 | 86% |
| Kindful Hospice Contracted [320434] | $3,099 | 93% |
| Tricare | $3,099 | 93% |
| Cross Timbers Hospice [20098] | $3,099 | 93% |
| Kindful Hospice [20434] | $3,099 | 93% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $3,099 | 93% |
| Halo Hcr Inc Hospice Contracted [320432] | $3,099 | 93% |
| Pace Of The Ozarks Contracted [320518] | $3,099 | 93% |
| Dept Of Veteran Affairs Contracted [320106] | $3,099 | 93% |
| Medicare (plans) | $3,099 - $3,225 | 93% |
| Elara Caring Aspire Hospice [20433] | $3,099 | 93% |
| Mercy Hospice Okc [20252] | $3,099 | 93% |
| Halo Hcr Inc Hospice [20432] | $3,099 | 93% |
| Home State Health Plan Contracted [320187] | $3,159 | 94% |
| Ambetter / Centene | $3,159 | 94% |
| Providrs Care Network Contracted [320484] | $6,002 | 180% |
| Health Choice Contracted [320166] | $6,489 | 194% |
Consumer Guidance & Cost Commentary
For a knee arthroscopy with meniscus repair at Mercy Hospital Pittsburg, Inc., the facility's cash median price of $12,698 is significantly lower than the gross charge of $19,536, offering a substantial discount for self-pay patients. While the facility's negotiated rates with major payers like Blue Cross Blue Shield range from $483 to $4,884, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket or utilizing prompt-pay discounts. It is crucial to verify "self-pay" or "prompt-pay" rates directly with the hospital before scheduling, as these upfront payment incentives can bypass the administrative costs and inflated negotiated rates that typically accompany insurance billing.
When evaluating the true cost of this procedure, it is essential to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster. The Medicare allowed amount for this service is $3,342.87, which serves as a scientifically validated baseline for fair pricing; commercial negotiated rates often average between 200% and 300% of this figure, whereas fair pricing is typically defined as 120% to 150%. Patients should be aware that balance billing is largely prohibited for emergency and non-emergency services at in-network facilities under the No Surprises Act, and if unexpected bills arise, they should request a formal itemized audit to identify errors such as code unbundling or services not rendered before agreeing to any payment plan.