CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Mount Carmel St Ann's

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $8,144
  • Cash Discount Price: $36,438
  • vs. Medicare Baseline: 2.44x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Mount Carmel St Ann's is $8,144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36,438. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.44x the Medicare baseline. Located in 500 South Cleveland Avenue, Westerville, OH.
Cash / Self-Pay
$36,438

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,144

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: $36,438 (1090%)
Insurance Median: $8,144 (244%)
Cash: $36,438 (1090% of Medicare)
Ins. Median: $8,144 (244% 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 244% of the Medicare baseline (a markup of 144%). 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
Crime Victim Assistance $632 19%
Ohio Safe Program $632 19%
American Postal Workers Secondary $5,933 177%
Cigna $5,933 177%
Health Partners $5,933 177%
Healthgram $5,933 177%
Mvp $5,933 177%
Priority Health $5,933 177%
Medicare (plans) $6,151 - $7,346 184%
Aetna $6,857 - $8,144 205%
Blue Cross Blue Shield $6,857 - $26,099 205%
UnitedHealthcare $6,994 - $12,804 209%
Hospice Mount Carmel $6,997 209%
The Health Plan $7,137 213%
Rural Carrier Health Benefit Plan $8,144 244%
Oscar $11,544 345%
Geha $12,804 383%
Enterprise Group Planning $13,503 404%
Custom Design Benefits $14,623 437%
Quality Care Partners $15,812 473%
Medical Mutual $17,193 - $24,894 514%
Western & Southern Financial Group $24,894 745%
Blue Benefit Administrators Of Massachusetts $26,099 781%
Blue Care Network $26,099 781%
Blue Distinction Transplant $26,099 781%
Blue Shield - Ca $26,099 781%
Blue Shield - Id (Regence) $26,099 781%
Blue Shield - Ny Highmark Northeastern $26,099 781%
Blue Shield - Ny Highmark Western $26,099 781%
Blue Shield - Pa (Highmark) $26,099 781%
Blue Shield - Wa (Regence) $26,099 781%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 South Cleveland Avenue, Westerville, OH 43081
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals