CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Elmhurst Hospital Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $2,361
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Elmhurst Hospital Center is $2,361. 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 0.71x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,361

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: $2,361 (71%)

Ins. Median: $2,361 (71% 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
Aetna	$257 - $558	8%
Emblem	$319 - $5,759	10%
Magnacare	$320	10%
Oxford	$362 - $410	11%
United	$434 - $2,721	13%
Healthfirst	$501 - $4,897	15%
Oscar	$614	18%
Wellcare	$676	20%
Fidelis	$901 - $5,452	27%
Metroplus	$1,980 - $4,897	59%
Amidacare	$2,176	65%
Blue Cross Blue Shield	$2,176 - $7,700	65%
Carelon	$2,176 - $6,256	65%
Senior Whole Health	$2,176	65%
United Behavioral Health	$2,176 - $2,394	65%
Affinity	$2,220 - $4,897	66%
Carelon (Amida Care)	$2,220	66%
Vnsny	$2,220 - $3,840	66%
Elderplan	$3,840	115%
Vaccn	$3,840	115%
Centers Plan For Healthy Living	$3,993	119%
Centerlight	$4,812	144%
Multiplan	$7,700	230%
Local 1199	$8,181	245%
Villagecare Max	$8,181	245%

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 Elmhurst Hospital 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.