CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $4,529
Cash Discount Price: $5,896
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Baylor Scott & White Medical Center - Marble Falls is $4,529. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,896. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.35x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$5,896

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,529

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: $5,896 (176%)

Insurance Median: $4,529 (135%)

Cash: $5,896 (176% of Medicare)

Ins. Median: $4,529 (135% 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	$66 - $4,927	2%
Superior Health Plan	$1,088 - $2,854	33%
Baylor Scott & White Health Plan	$2,712 - $4,709	81%
Humana	$2,854 - $7,006	85%
Triwest	$2,854	85%
Corvel	$2,990	89%
Prime Health Services	$2,990	89%
American Health Plan	$2,997	90%
Healthspring	$2,997	90%
Procare Advantage	$2,997	90%
UnitedHealthcare	$3,282 - $4,845	98%
Sedgwick	$4,267	128%
Cigna	$5,051 - $6,038	151%
Midcoast	$5,405	162%
Quiktrip	$5,405	162%
University Of Mary Hardin-Baylor	$5,700	171%
Independent Medical System	$5,896	176%
Curative	$6,388	191%
First Health	$6,879	206%
Bluebell Creameries	$7,371	220%
Healthsmart	$7,371 - $11,621	220%
Private Health Care System	$7,371	220%
Three Rivers	$8,845	265%
Aetna	$10,200	305%

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 $5,896.
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 Baylor Scott & White Medical Center - Marble Falls 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.