CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Holton Community Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $3,083
  • Cash Discount Price: $2,742
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Holton Community Hospital is $3,083. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,742. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.92x the Medicare baseline. Located in 1110 Columbine Drive, Holton, KS.
Cash / Self-Pay
$2,742

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,083

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: $2,742 (82%)
Insurance Median: $3,083 (92%)
Cash: $2,742 (82% of Medicare)
Ins. Median: $3,083 (92% 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
UnitedHealthcare $469 - $5,759 14%
Aetna $469 - $5,759 14%
Humana $474 - $3,083 14%
Kansas Superior Select - All Plans $479 - $3,113 14%
Medicaid / KanCare $494 - $5,759 15%
Blue Cross Blue Shield $3,801 114%
Preferred Health Fn Select - All Other Plans $4,780 143%
Preferred Health Freedom $4,780 143%
Preferred Health Professionals $4,780 143%
Wppa Providers - All Plans $5,471 164%

Consumer Guidance & Cost Commentary

For the knee arthroscopy with meniscus repair at Holton Community Hospital in Holton, Kansas, the cash median price is $2,742, while the facility's negotiated rates with insurance payers range from $469 to $5,759. It is important to note that cash payments can sometimes be more cost-effective for patients with high-deductible plans, as the negotiated rates paid by insurers often exceed the cash price. The facility's cash rate is significantly lower than the gross charge of $3,656, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the lowest possible rate.

This procedure is billed under CPT code 29881, and the facility's cash price of $2,742 is compared against the Medicare benchmark of $3,342.87, which serves as a scientifically validated baseline for healthcare costs. While the data does not provide specific county or state average figures for this procedure, the significant gap between the cash price and the highest negotiated rates highlights the importance of verifying your specific plan's allowed amount. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services from out-of-network providers at in-network facilities under the No Surprises Act, and they should request a full itemized bill to identify any errors or unbundled charges before finalizing payment.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1110 Columbine Drive, Holton, KS 66436
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals