CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Columbia Memorial Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $598
Cash Discount Price: $1,067
vs. Medicare Baseline: 0.18x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Columbia Memorial Hospital is $598. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,067. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.18x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.

Cash / Self-Pay

$1,067

Average discount available for prompt cash payment at this facility.

Insurance Median

$598

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: $1,067 (32%)

Insurance Median: $598 (18%)

Cash: $1,067 (32% of Medicare)

Ins. Median: $598 (18% 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
UnitedHealthcare	$236 - $707	7%
Medicaid / KanCare	$308 - $2,172	9%
Mvp	$412 - $4,560	12%
Cdphp	$415 - $5,379	12%
Medicare (plans)	$442 - $589	13%
Blue Cross Blue Shield	$492 - $4,017	15%
Tricare	$501 - $589	15%
Hamaspik	$551 - $5,222	16%
Fidelis	$560 - $4,886	17%
Blue Shield Highmark	$596 - $626	18%
Aetna	$607 - $6,148	18%
Cigna	$738 - $762	22%
Emblem Health Ghi	$807	24%
Empire Plan Nyship	$4,951	148%
Blue Shield	$5,581	167%
Herrington Diversified Pdh	$5,759	172%

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 $1,067.
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 Columbia Memorial 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.