CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: UPMC Presbyterian Shadyside

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $2,415
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.72x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at UPMC Presbyterian Shadyside is $2,415. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.72x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,415

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%)

Insurance Median: $2,415 (72%)

Ins. Median: $2,415 (72% 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
Upmc Health Plan	$598 - $1,237	18%
Aetna	$707 - $3,403	21%
Highmark Wholecare (Prev Gateway)	$806 - $3,341	24%
Health Partners Plans (Jefferson Health Plan)	$820	25%
Geisinger	$846	25%
Amerihealth Caritas	$860 - $3,341	26%
Pa Health & Wellness	$926 - $3,341	28%
Blue Cross Blue Shield	$1,041 - $7,096	31%
UnitedHealthcare	$1,118 - $3,341	33%
Upmc Work Partners	$2,077	62%
Multiplan	$2,415	72%
Cigna	$3,341	100%

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 $X.
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 UPMC Presbyterian Shadyside 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.