CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Kaleida Health

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $4,238
Cash Discount Price: $1,680
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Kaleida Health is $4,238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,680. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.27x the Medicare baseline. Located in 100 High Street, Buffalo, NY.

Cash / Self-Pay

$1,680

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,238

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: $1,680 (50%)

Insurance Median: $4,238 (127%)

Cash: $1,680 (50% of Medicare)

Ins. Median: $4,238 (127% 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
Ghi/Emblem Health	$615 - $5,514	18%
Ghi/Emblem Health - Wchob	$615 - $769	18%
Aetna	$641 - $4,525	19%
Magnacare	$641 - $4,229	19%
Magnacare - Wchob	$641 - $4,229	19%
Univera	$980 - $5,692	29%
Univera - Wchob	$980 - $5,535	29%
Independent Health Association	$2,376 - $6,464	71%
Independent Health Association - Wchob	$2,465 - $6,622	74%
Blue Cross Blue Shield	$2,785 - $15,241	83%
Tricare	$3,880	116%
Wellcare	$4,248	127%
Fidelis	$4,411	132%
UnitedHealthcare	$4,432	133%
Cigna	$4,779 - $5,800	143%

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 $1,680.
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 Kaleida Health 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.