CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Nationwide Children's Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $2,051
Cash Discount Price: $2,462
vs. Medicare Baseline: 0.61x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Nationwide Children's Hospital is $2,051. 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 0.61x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$2,462

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,051

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: $2,051 (61%)

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

Ins. Median: $2,051 (61% 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
Tricare	$490 - $3,082	15%
Caresource	$743 - $5,014	22%
Humana	$1,218 - $2,813	36%
UnitedHealthcare	$1,445 - $2,813	43%
Ohio Ppo Connect	$1,548	46%
Osu	$1,548	46%
Blue Cross Blue Shield	$1,644 - $2,813	49%
Aetna	$1,738 - $2,051	52%
Mmo	$1,969	59%
Cigna	$2,051	61%
Front Path Health Coalition	$2,051	61%
Ohc	$2,051	61%
Ohg	$2,051	61%
The Health Plan	$2,051	61%
Amerihealth	$2,813	84%
Bchp	$2,813	84%
Molina	$2,813	84%

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 Nationwide Children's 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.