CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $3,099
  • Cash Discount Price: $10,463
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Mercy Specialty Hospital Southeast Kansas is $3,099. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,463. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.93x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$10,463

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,099

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: $10,463 (313%)
Insurance Median: $3,099 (93%)
Cash: $10,463 (313% of Medicare)
Ins. Median: $3,099 (93% 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
Medicaid / KanCare $297 - $3,099 9%
Blue Cross Blue Shield $493 - $3,785 15%
Indian Health Service Contracted [320198] $493 15%
Provider Partners Health Plans Contracted [320450] $540 16%
UnitedHealthcare $2,766 - $3,099 83%
Aetna $2,889 - $3,099 86%
Humana $2,889 - $3,159 86%
Show-Me Health Administrators Contracted [320483] $3,034 91%
Mercy Benefit Admin Contracted [320251] $3,034 91%
Medical Associates Health Contracted [320444] $3,099 93%
Qual Choice Contracted [320325] $3,099 93%
Cross Timbers Hospice [20098] $3,099 93%
Globalhealth Contracted [320145] $3,099 93%
Mercy Mgd Behavioral Health Contracted [320259] $3,099 93%
Pace Of The Ozarks Contracted [320518] $3,099 93%
Medicare (plans) $3,099 93%
Kindful Hospice Contracted [320434] $3,099 93%
Kindful Hospice [20434] $3,099 93%
Elara Caring Aspire Hospice [20433] $3,099 93%
Cherokee Nation Health Serv Contracted [320066] $3,099 93%
Tricare $3,099 93%
Mercy Hospice Okc [20252] $3,099 93%
Halo Hcr Inc Hospice Contracted [320432] $3,099 93%
Cigna $3,099 93%
Halo Hcr Inc Hospice [20432] $3,099 93%
Dept Of Veteran Affairs Contracted [320106] $3,159 94%
Centivo Contracted [320505] $3,159 94%
Health Systems Inc Contracted [320174] $5,369 161%
Insurance System Inc Contracted [320465] $5,369 161%
Benefit Management Contracted [320052] $5,369 161%
United Medical Resources Contracted [320454] $5,369 161%
Point C Contracted [320238] $5,369 161%
Healthscope Contracted [320182] $5,369 161%
Health Choice Contracted [320166] $5,516 165%
Providrs Care Network Contracted [320484] $6,002 180%

Consumer Guidance & Cost Commentary

For a knee arthroscopy with meniscus repair at Mercy Specialty Hospital Southeast Kansas, the facility's cash median price is $10,463, while the lowest negotiated rates across 35 payers range from $297 for Medicaid/KanCare to $6,002 for specific contracted plans. Notably, the cash price is significantly lower than the median negotiated amount of $3,099 reported for many commercial plans, meaning patients with high-deductible or out-of-pocket plans might save money by paying cash directly rather than relying on insurance, which often results in higher allowed amounts due to administrative overhead. While the facility's cash rate is competitive, patients should verify their specific plan's allowed amount before scheduling, as some insurers may negotiate rates higher than the cash price depending on network tiering and contract dynamics.

To avoid unexpected costs, consumers should request a prompt-pay discount if paying in full upfront, which can reduce the bill by 20% to 50% by bypassing costly insurance claims processing. Additionally, patients should insist on an itemized billing audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or charges for services not rendered. If a balance bill arises from an out-of-network provider at an in-network facility, the No Surprises Act generally protects patients from paying the difference between the provider's chargemaster and the insurer's allowed amount, so patients should dispute any surprise charges in writing rather than paying immediately out of fear.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1619 K 66, Galena, KS 66739
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals