CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Montefiore Mount Vernon Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $3,549
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Montefiore Mount Vernon Hospital is $3,549. 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 1.06x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,549

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: $3,549 (106%)

Ins. Median: $3,549 (106% 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
American Postal Workers	$560 - $17,650	17%
UnitedHealthcare	$560 - $17,650	17%
Metroplus	$634 - $5,310	19%
Healthfirst	$1,332 - $4,084	40%
Amidacare	$1,964	59%
Blue Cross Blue Shield	$1,964 - $10,052	59%
Emblem	$1,964 - $18,107	59%
Fidelis	$1,964 - $4,084	59%
Medicaid / KanCare	$1,964	59%
Molina Healthcare Of Ny Affinity	$1,964 - $5,636	59%
Mvp	$1,964 - $5,223	59%
Wellcare	$1,984 - $4,166	59%
Hamaspik	$2,063 - $2,122	62%
Vnsny Choice	$2,259 - $4,084	68%
Vnsny Select Health	$2,259	68%
Oscar	$3,549 - $7,276	106%
Point Comfort	$4,084	122%
Villagecaremax	$4,084	122%
Centerlight	$4,207 - $4,493	126%
Elderplan	$4,207	126%
Partners Health Plan	$4,289	128%
Longevity	$4,452	133%
Humana	$4,493	134%
Aetna	$5,250 - $5,873	157%
Northwell	$10,987	329%

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 $X.
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 Montefiore Mount Vernon 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.