CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Scott County Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $3,728
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Scott County Hospital is $3,728. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.12x the Medicare baseline. Located in 201 Albert Avenue, Scott City, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,728

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%)
Insurance Median: $3,728 (112%)
Ins. Median: $3,728 (112% 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 $1,049 - $5,903 31%
Wppa $1,200 - $3,728 36%
Humana $2,610 78%
Blue Cross Blue Shield $3,595 108%
Aetna $5,593 167%

Consumer Guidance & Cost Commentary

For this knee arthroscopy with meniscus repair at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $1,049 to $5,903 across five payers, with a median negotiated rate of $3,728. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data does not provide specific cash or self-pay prices for this procedure. However, it is important to note that cash payments can sometimes be more affordable for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. Since the cash median is not available in this report, patients should directly contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount when paid in full upfront.

The facility's pricing is benchmarked against the Medicare rate of $3,342.87, showing a markup factor of 1.1, which indicates the commercial rates are slightly higher than the federal baseline. This aligns with the general principle that commercial negotiated rates often exceed Medicare benchmarks due to administrative costs and contract dynamics. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, unexpected charges can still occur from ancillary services if they are not covered by the contract. To ensure transparency and avoid errors, consumers should request a full itemized bill before paying, as summary bills may obscure individual line items or unbundled charges that could be disputed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Albert Avenue, Scott City, KS 67871
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals