CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Southern Ocean Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $5,155
Cash Discount Price: $3,546
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Southern Ocean Medical Center is $5,155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,546. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.54x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$3,546

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,155

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: $3,546 (106%)

Insurance Median: $5,155 (154%)

Cash: $3,546 (106% of Medicare)

Ins. Median: $5,155 (154% 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
Karna	$1,144	34%
UnitedHealthcare	$1,189 - $14,007	36%
Clover	$1,381	41%
Aetna	$1,420 - $9,383	42%
Seoul Medical Group	$1,573	47%
Qualcare	$2,744 - $6,967	82%
Horizon	$2,897 - $7,015	87%
Wellcare	$3,546	106%
Blue Cross Blue Shield	$3,546	106%
Vaccn	$3,546	106%
United Community/Americhoice	$3,723	111%
Cigna	$4,412 - $6,138	132%
Bergen Risk	$5,755	172%
Multiplan - PHCS	$6,522	195%
Amerihealth	$6,663 - $7,547	199%
Oxford	$11,243	336%
Brighton Health Plan	$15,984	478%

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 $3,546.
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 Southern Ocean Medical Center 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.