CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Samaritan Hospital of Troy, New York

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $8,204
  • Cash Discount Price: $5,765
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Samaritan Hospital of Troy, New York is $8,204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,765. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.45x the Medicare baseline. Located in 2215 Burdett Avenue, Troy, NY.
Cash / Self-Pay
$5,765

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,204

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: $5,765 (172%)
Insurance Median: $8,204 (245%)
Cash: $5,765 (172% of Medicare)
Ins. Median: $8,204 (245% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 245% of the Medicare baseline (a markup of 145%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Capital District Physicians Health Plan $363 - $10,304 11%
Medicaid / KanCare $363 - $6,535 11%
UnitedHealthcare $2,160 - $15,063 65%
Blue Cross Blue Shield $4,003 - $9,398 120%
Medicare (plans) $4,083 - $4,563 122%
Eddy Seniorcare Pace $4,084 122%
Secure Horizons Ma Pffs $4,163 125%
Aetna $4,323 - $10,500 129%
Hudson Headwaters Pace $4,411 132%
Nascentia Health Plus $4,575 137%
Blue Shield - Ny Highmark Northeastern $4,777 - $8,204 143%
Mvp $6,753 - $7,877 202%
Fidelis Care $7,352 220%
Blue Shield - Ca $8,204 245%
Blue Shield - Id (Regence) $8,204 245%
Blue Shield - Ny Highmark Western $8,204 245%
Blue Shield - Pa (Highmark) $8,204 245%
Blue Shield - Wa (Regence) $8,204 245%
Allegiance $9,024 270%
American Postal Workers Secondary $9,024 270%
Cigna $9,024 270%
Diversified Administrators $9,024 270%
Health Partners $9,024 270%
Priority Health $9,024 270%
Tufts Health Plan $9,024 270%
Webtpa $9,024 270%
Wellpath $9,190 275%
Bcn Domestic $9,398 281%
Blue Care Network $9,398 281%
Unicare $9,398 281%
Emblem Health $9,706 290%
Nova $9,706 290%
1199 National Benefit Fund $10,500 314%
Allied Benefit Systems $10,500 314%
Asr Health Benefits $10,500 314%
Christian Brother Services $10,500 314%
Geha $10,500 314%
Lucent Health $10,500 314%
Luminare Health $10,500 314%
Medical Mutual $10,500 314%
Meritain $10,500 314%
Trustmark Small Business Benefits $10,500 314%
Harvard Pilgrim Healthcare $15,063 451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals