CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Glens Falls Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $538
Cash Discount Price: $2,462
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Glens Falls Hospital is $538. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,462. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.16x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$2,462

Average discount available for prompt cash payment at this facility.

Insurance Median

$538

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: $2,462 (74%)

Insurance Median: $538 (16%)

Cash: $2,462 (74% of Medicare)

Ins. Median: $538 (16% 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
Medicaid / KanCare	$308 - $499	9%
Cdphp	$349 - $6,880	10%
Medicare (plans)	$384 - $513	11%
UnitedHealthcare	$384 - $6,054	11%
Emblem Health Ghi	$436 - $513	13%
Tricare	$436 - $513	13%
Blue Cross Blue Shield	$460 - $6,259	14%
Mvp	$481 - $4,578	14%
Aetna	$513 - $5,601	15%
Fidelis	$513 - $4,905	15%
Blue Shield Highmark	$536 - $602	16%
Cigna	$751 - $909	22%
Emblem	$2,649	79%
Magnacare	$3,840	115%
Empire Plan Nyship	$6,259	187%
Blue Shield	$6,855	205%

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 $2,462.
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 Glens Falls 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.