CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Garnet Health Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $3,956
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Garnet Health Medical Center is $3,956. 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 1.18x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,956

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: $3,956 (118%)

Ins. Median: $3,956 (118% 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
Magnacare	$1,567 - $2,507	47%
Aetna	$2,033 - $4,084	61%
Local 1199	$2,033 - $3,827	61%
Mvp	$2,749	82%
Emblem Health	$2,872	86%
UnitedHealthcare	$3,262	98%
Fidelis	$4,166	125%
Wellcare	$4,178	125%
Blue Cross Blue Shield	$5,377 - $5,501	161%
Cigna	$5,386	161%
Cdphp	$6,647	199%
Rojw	$7,148	214%
Northwell Direct	$8,373	250%
Geisinger Health Plan	$10,211	305%

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 Garnet Health 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.