CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: West Penn Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $1,004
Cash Discount Price: $415
vs. Medicare Baseline: 0.30x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at West Penn Hospital is $1,004. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $415. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.30x the Medicare baseline. Located in 4800 Friendship Avenue, Pittsburgh, PA.

Cash / Self-Pay

$415

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,004

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: $415 (12%)

Insurance Median: $1,004 (30%)

Cash: $415 (12% of Medicare)

Ins. Median: $1,004 (30% 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
Amerihealth	$571 - $3,277	17%
University Of Pittsburgh Medical Center	$598 - $1,025	18%
Aetna	$652 - $10,332	20%
Highmark	$676 - $7,921	20%
Pennsylvania Health And Wellness	$717 - $1,398	21%
Highmark Wholecare	$750 - $3,309	22%
Geisinger	$788 - $1,491	24%
UnitedHealthcare	$788 - $10,953	24%
Cigna	$868 - $10,357	26%
American Health Plans	$3,121	93%
Life Pittsburgh	$3,121	93%
Martin'S Point	$3,121	93%
Medicare (plans)	$3,215	96%
Humana	$3,309	99%
Molina	$3,402	102%
Medical Mutual	$10,357	310%

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 $415.
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 West Penn 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.