CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Mercy Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $1,209
Cash Discount Price: $1,965
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Mercy Medical Center is $1,209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,965. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.36x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.

Cash / Self-Pay

$1,965

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,209

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: $1,965 (59%)

Insurance Median: $1,209 (36%)

Cash: $1,965 (59% of Medicare)

Ins. Median: $1,209 (36% 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
Summacare	$335 - $2,998	10%
United	$454 - $2,998	14%
Caresource	$468 - $1,525	14%
Buckeye	$477 - $1,525	14%
Amerihealth	$499 - $1,629	15%
Molina	$499 - $1,555	15%
Aetna	$516 - $3,023	15%
Blue Cross Blue Shield	$516 - $2,998	15%
Cigna	$516 - $3,088	15%
Humana	$516 - $2,998	15%
The Health Plan	$516 - $2,698	15%
Mmo	$532 - $4,898	16%
Communicare	$542 - $3,148	16%
Perennial Health	$557 - $3,238	17%
Zing Health	$568 - $3,298	17%
Aultcare	$593	18%
Oscar	$807	24%
Ohcp	$1,176	35%
Omas	$1,512	45%
Phphi	$1,814	54%
Gms	$2,116	63%
Immergrun	$2,267	68%
Multiplan	$2,721	81%

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 $1,965.
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 Mercy 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.