CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: HCA Houston Healthcare Tomball

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $4,973
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at HCA Houston Healthcare Tomball is $4,973. 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 1.49x the Medicare baseline. Located in 605 Holderrieth, Tomball, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,973

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: $4,973 (149%)

Ins. Median: $4,973 (149% 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
Texas Childrens Healthplans	$1,088	33%
United	$1,168 - $6,800	35%
Molina Healthcare	$1,197	36%
Community Health Choice Mcd	$1,219	36%
Humana	$1,360 - $4,690	41%
Aetna	$1,374 - $6,717	41%
Superior Health Plan	$2,369	71%
Blue Cross Blue Shield	$4,763 - $6,351	142%
Healthcare Highways	$4,988	149%
Curative Administrators	$5,849	175%
Evry Health	$6,077	182%
Oscar	$7,014	210%
Cigna	$10,908 - $14,052	326%

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 HCA Houston Healthcare Tomball 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.