CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Smith County Memorial Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $4,559
  • Cash Discount Price: $4,850
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Smith County Memorial Hospital is $4,559. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,850. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.36x the Medicare baseline. Located in 921 E. Highway 36, Smith Center, KS.
Cash / Self-Pay
$4,850

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,559

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: $4,850 (145%)
Insurance Median: $4,559 (136%)
Cash: $4,850 (145% of Medicare)
Ins. Median: $4,559 (136% 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 $3,395 - $4,850 102%
Blue Cross Blue Shield $3,801 114%
Multiplan-All Plans $4,365 131%
Wppa-All Plans $4,559 136%
Health Partners Of Ks Ppo-All Plans $4,608 138%
Midlands Choice-All Plans $4,608 138%
UnitedHealthcare $4,608 138%

Consumer Guidance & Cost Commentary

For the CPT code 29881, representing a knee arthroscopy with meniscus repair, Smith County Memorial Hospital in Smith Center, KS, lists a cash median price of $4,850.00. This cash rate is notably higher than the state of Kansas average, which is $4,365.00. While the facility offers a negotiated rate of $4,559.00 for in-network patients, this amount remains above the state average. Patients with high-deductible plans should consider that paying the cash price directly may be more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price due to administrative overhead and contract dynamics. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.

Regarding billing transparency, patients should be aware that commercial insurance rates are often inflated compared to the true cost of care, which is best represented by the Medicare benchmark. For this procedure, the Medicare amount is $3,342.87, and the facility's negotiated rate is approximately 136% of the Medicare rate, which falls within the typical range of 120% to 150% considered fair. If a patient receives a bill significantly higher than the allowed amount, it may indicate balance billing, where the provider charges the difference between the full chargemaster and the insurance payment. To protect against unexpected costs, patients should request a full itemized bill before paying and dispute any errors in writing, as over 80% of hospital bills contain mistakes that can be corrected through a formal audit.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 921 E. Highway 36, Smith Center, KS 66967
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals