CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Highpoint Health-Sumner With Ascension Saint Thoma

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $4,880
Cash Discount Price: $8,624
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Highpoint Health-Sumner With Ascension Saint Thoma is $4,880. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,624. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.46x the Medicare baseline. Located in 555 Hartsville Pike, Gallatin, TN.

Cash / Self-Pay

$8,624

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,880

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: $8,624 (258%)

Insurance Median: $4,880 (146%)

Cash: $8,624 (258% of Medicare)

Ins. Median: $4,880 (146% 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
Blue Cross Blue Shield	$1,778 - $1,932	53%
Cigna	$4,880	146%
UnitedHealthcare	$5,349	160%

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 $8,624.
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 Highpoint Health-Sumner With Ascension Saint Thoma 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.