CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Penn State Health St. Joseph

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $3,794
Cash Discount Price: $5,486
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Penn State Health St. Joseph is $3,794. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,486. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.13x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$5,486

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,794

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: $5,486 (164%)

Insurance Median: $3,794 (113%)

Cash: $5,486 (164% of Medicare)

Ins. Median: $3,794 (113% 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 Caritas]	$2,829 - $3,328	85%
[Highmark Wholecare]	$2,829 - $3,328	85%
[Geisinger]	$2,995 - $15,214	90%
[Health Partners Plans]	$3,095 - $3,394	93%
[Pa Health & Wellness]	$3,112 - $3,428	93%
[Highmark]	$3,295 - $18,087	99%
UnitedHealthcare	$3,328 - $14,278	100%
[Cbc]	$3,328 - $11,148	100%
[Ibc]	$3,328 - $10,482	100%
Aetna	$3,361 - $10,772	101%
Humana	$3,361	101%
[Healthspring]	$3,361	101%
[Upmc]	$3,394 - $15,581	102%
[Point Comfort Underwriters]	$4,160	124%
Cigna	$12,939	387%
[Highmark Choice Blue]	$14,470	433%
[Highmark Aca]	$15,193	454%
[Preferred Healthcare Systems]	$15,818	473%
[First Health]	$16,872	505%
[Multiplan]	$16,872	505%

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 $5,486.
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 Penn State Health St. Joseph 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.