CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Trinity Health Oakland Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $3,260
Cash Discount Price: $20,629
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Trinity Health Oakland Hospital is $3,260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,629. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.98x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.

Cash / Self-Pay

$20,629

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,260

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: $20,629 (617%)

Insurance Median: $3,260 (98%)

Cash: $20,629 (617% of Medicare)

Ins. Median: $3,260 (98% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Priority Health	$1,117 - $1,241	33%
U Of M Health Plan	$1,171	35%
Asr Health Benefits	$1,403	42%
Caresource	$1,403	42%
Hap	$1,403	42%
Varipro	$1,403	42%
Medicaid / KanCare	$1,792 - $1,828	54%
Blue Cross Blue Shield	$1,828 - $3,334	55%
Aetna	$3,195	96%
Blue Care Network Advantage	$3,195	96%
Medicare (plans)	$3,195 - $3,260	96%
Align Senior Care	$3,260	98%
Hospice Advantage	$3,260	98%
Bcn Domestic	$3,334	100%
Blue Benefit Administrators Of Massachusetts	$3,334	100%
Blue Care Network	$3,334	100%
Blue Distinction Transplant	$3,334	100%
Blue Shield - Ca	$3,334	100%
Blue Shield - Id (Regence)	$3,334	100%
Blue Shield - Ny Highmark Northeastern	$3,334	100%
Blue Shield - Ny Highmark Western	$3,334	100%
Blue Shield - Pa (Highmark)	$3,334	100%
Blue Shield - Wa (Regence)	$3,334	100%
Health Choices	$3,334	100%
Kaiser Domestic	$3,334	100%
UnitedHealthcare	$3,358	100%
Cca - Zing Health	$3,451	103%
Longevity Ipa Of Michigan Llc Health Plan Isnp	$3,674	110%
Molina Marketplace	$4,238	127%
Health Cost Solutions	$5,053	151%
Vitalcore	$5,053	151%
Wellpath	$5,053	151%
Employee Benefit Logistic	$7,522	225%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $20,629.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 29881.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Trinity Health Oakland Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 29881.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.