CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Pratt Regional Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $1,395
  • Cash Discount Price: $1,073
  • vs. Medicare Baseline: 0.42x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Pratt Regional Medical Center is $1,395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,073. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.42x the Medicare baseline. Located in 200 Commodore St, Pratt, KS.
Cash / Self-Pay
$1,073

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,395

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: $1,073 (32%)
Insurance Median: $1,395 (42%)
Cash: $1,073 (32% of Medicare)
Ins. Median: $1,395 (42% 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
Christian Health Aid $293 - $4,052 9%
UnitedHealthcare $324 - $5,511 10%
Health Partners Of Kansas $332 - $4,593 10%
Aetna $351 - $4,863 10%
Choicecare $390 - $5,403 12%
Celtic Insurance Company $3,000 90%
Healthy Blue $3,090 92%

Consumer Guidance & Cost Commentary

For the CPT code 29881, representing a knee arthroscopy with meniscus repair at Pratt Regional Medical Center in Pratt, KS, the facility's cash median rate is $1,073.00. This cash price is notably lower than the facility's gross charge of $1,533.00 and the Medicare benchmark of $3,342.87. While the data does not provide a specific county or state average for this procedure, the cash rate of $1,073.00 serves as a critical baseline for patients with high-deductible plans or those without insurance. In such cases, paying the cash price directly can be significantly cheaper than relying on insurance, as commercial negotiated rates often exceed the cash amount due to administrative overhead and contract structures. Patients should verify if their specific plan has a deductible that would otherwise require them to pay the higher negotiated rate before scheduling.

Insurance payers for this service have negotiated rates ranging from $293 to $5,511, with most plans falling between $300 and $5,400. Notably, Celtic Insurance Company and Healthy Blue have fixed negotiated rates of $3,000 and $3,090, respectively, which are substantially higher than the cash price. To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. Additionally, since the No Surprises Act prohibits balance billing for out-of-network providers at in-network facilities, patients can avoid unexpected charges by ensuring their care is properly classified.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Commodore St, Pratt, KS 67124
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals