CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Shriners Hospital for Children - Portland

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $4,121
Cash Discount Price: $7,171
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Shriners Hospital for Children - Portland is $4,121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,171. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.23x the Medicare baseline. Located in 3101 Sw Sam Jackson Park Road, Portland, OR.

Cash / Self-Pay

$7,171

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,121

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: $7,171 (215%)

Insurance Median: $4,121 (123%)

Cash: $7,171 (215% of Medicare)

Ins. Median: $4,121 (123% 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
Samaritan Health Services	$630	19%
Cigna	$1,664	50%
Aetna	$1,924	58%
UnitedHealthcare	$1,982	59%
Moda Eastern Oregon	$2,895	87%
Ambetter / Centene	$4,121	123%
Sana Benefits	$5,067	152%
Pacific Source Health Plans	$5,972	179%
Providence Health Plan	$6,120	183%
Blue Cross Blue Shield	$11,255	337%
Moda	$12,667	379%

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 $7,171.
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 Shriners Hospital for Children - Portland 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.