CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Forks Community Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $3,555
  • Cash Discount Price: $5,890
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Forks Community Hospital is $3,555. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,890. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.06x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.
Cash / Self-Pay
$5,890

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,555

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: $5,890 (176%)
Insurance Median: $3,555 (106%)
Cash: $5,890 (176% of Medicare)
Ins. Median: $3,555 (106% 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.

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
Medicare (plans) $318 10%
Medicaid / KanCare $2,360 - $2,895 71%
Coordinated Care (Mco) Mcd-All Plans $2,549 - $2,950 76%
UnitedHealthcare $3,038 - $6,714 91%
Community Health Network Mcr-All Other Plans $3,071 - $3,555 92%
Humana $3,071 - $3,555 92%
Tricare $3,071 - $3,555 92%
Triwest-All Plans $3,071 - $3,555 92%
Ambetter / Centene $3,563 - $4,123 107%
Wellcare Med Adv - All Plans $3,563 - $4,123 107%
Regence-All Other Plans $3,930 - $4,548 118%
Community Health Exchange $4,436 - $5,134 133%
Molina Commercial-All Other Plans $6,279 - $7,267 188%
Blue Cross Blue Shield $6,484 - $7,504 194%
Aetna $6,825 - $7,899 204%
Cigna $6,825 - $7,899 204%
First Choice-All Plans $6,825 - $7,899 204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 Bogachiel Way, Forks, WA 98331
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals