CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Legacy Mount Hood Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $9,058
Cash Discount Price: $1,011
vs. Medicare Baseline: 2.71x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Legacy Mount Hood Medical Center is $9,058. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,011. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.71x the Medicare baseline. Located in 24800 Se Stark Street, Gresham, OR.

Cash / Self-Pay

$1,011

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,058

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: $1,011 (30%)

Insurance Median: $9,058 (271%)

Cash: $1,011 (30% of Medicare)

Ins. Median: $9,058 (271% 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 271% of the Medicare baseline (a markup of 171%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Kaiser	$3,637 - $7,274	109%
Atrio	$3,746	112%
Aetna	$3,819 - $13,746	114%
Healthnet	$3,855 - $10,400	115%
Careoregon	$3,928	118%
Ageright	$4,001	120%
Moda	$4,073 - $14,066	122%
Blue Cross Blue Shield	$7,716 - $11,310	231%
Cigna	$12,664 - $16,275	379%
UnitedHealthcare	$12,835	384%
First Health	$16,328	488%

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 $1,011.
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 Legacy Mount Hood 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.