Knee arthroscopy with meniscus repair
Facility: Phillips County Hospital
Billing Code: 29881 (CPT)
- CPT Billing Code: 29881
- Insurance Median: $4,405
- Cash Discount Price: $4,042
- vs. Medicare Baseline: 1.32x 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 |
|---|---|---|
| UnitedHealthcare | $3,804 - $4,755 | 114% |
| Blue Cross Blue Shield | $3,852 - $4,056 | 115% |
| Health Partners-All Plans | $4,755 | 142% |
| Medicaid / KanCare | $4,755 | 142% |
Consumer Guidance & Cost Commentary
For the CPT code 29881, representing a knee arthroscopy with meniscus repair at Phillips County Hospital in Phillipsburg, KS, the facility's cash median rate is $4,042.00, which is lower than the negotiated rates paid by major payers like UnitedHealthcare ($4,755.00) and Blue Cross Blue Shield ($4,056.00). This price transparency data indicates that patients with high-deductible plans or those without insurance may find the cash price more favorable than their insurance allowed amounts, as the facility's cash rate avoids the administrative markup inherent in commercial contracts. While the facility is a Critical Access Hospital owned by the local government, the cash median of $4,042.00 remains the primary benchmark for self-pay patients, and it is important to note that commercial negotiated rates can sometimes exceed cash prices due to the costs of claims processing and utilization reviews included in those contracts.
To minimize unexpected costs, patients should proactively request a "prompt-pay" discount or a self-pay rate before scheduling, as these upfront payments often bypass the higher negotiated rates and administrative fees associated with insurance billing. If a patient receives a bill after insurance submission, they should request an itemized billing audit to verify that no balance billing has occurred, particularly since the No Surprises Act protects against surprise bills for out-of-network services at in-network facilities. By comparing the facility's cash rate against the Medicare benchmark of $3,342.87, patients can see that the cash price reflects a reasonable markup over the federal cost basis, whereas the gross chargemaster rate of $4,755.00 represents