CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Hiawatha Community Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $706
  • Cash Discount Price: $1,720
  • vs. Medicare Baseline: 0.21x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Hiawatha Community Hospital is $706. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,720. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.21x the Medicare baseline. Located in 300 Utah Street, Hiawatha, KS.
Cash / Self-Pay
$1,720

Average discount available for prompt cash payment at this facility.

Insurance Median
$706

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: $1,720 (51%)
Insurance Median: $706 (21%)
Cash: $1,720 (51% of Medicare)
Ins. Median: $706 (21% 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
Ambetter / Centene $468 14%
Aetna $469 - $708 14%
Humana $469 14%
UnitedHealthcare $469 - $683 14%
Centrus Health Direct - All Plans $563 17%
Wppa Providrs Care - All Plans $634 19%
Multiplan - All Plans $704 21%
Oscar - All Plans $751 22%
Preferred Hlth - All Plans $762 23%
Cigna $993 30%
Blue Cross Blue Shield $1,027 31%
Midlands Choice - All Plans $1,196 36%
Healthy Blue Mcaid - All Plans $1,720 51%

Consumer Guidance & Cost Commentary

For the Knee arthroscopy with meniscus repair at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $1,720.00, which matches the facility's gross chargemaster rate. This cash price is significantly lower than the state average for this procedure, as indicated by the 20% variance compared to Medicare benchmarks. While many patients assume insurance will result in lower costs, the data shows that for this specific service, the cash rate is already at the maximum allowed amount for most payers, with negotiated rates ranging from $468 to $1,720 depending on the insurer. Patients with high-deductible plans or those without current coverage may find paying the cash price directly more cost-effective than facing a balance bill for the difference between the insurer's allowed amount and the full list price.

To minimize potential financial exposure, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling their visit, as hospitals often offer additional reductions for upfront payments that bypass insurance billing cycles. It is also critical to obtain a full itemized bill containing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled charges or services not rendered. If a balance bill arises from an out-of-network provider or unexpected ancillary services, patients should not pay immediately out of fear of credit damage; instead, they should dispute the bill with their insurer and request a No Surprises Act audit to ensure compliance with federal protections against surprise billing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Utah Street, Hiawatha, KS 66434
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals