CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Unitypoint Health - Meriter

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $2,786
Cash Discount Price: $7,236
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Unitypoint Health - Meriter is $2,786. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,236. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.83x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$7,236

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,786

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: $7,236 (216%)

Insurance Median: $2,786 (83%)

Cash: $7,236 (216% of Medicare)

Ins. Median: $2,786 (83% 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
Aspirus	$497 - $3,799	15%
Blue Cross Blue Shield	$497 - $10,922	15%
Illinicare	$497 - $3,134	15%
Prevea 360	$497 - $9,226	15%
UnitedHealthcare	$497 - $6,976	15%
Humana	$522 - $3,134	16%
Meridiancare	$522 - $3,134	16%
Health Partners Open Network	$1,055	32%
Medical Associates Health Plan	$1,649	49%
Wellmark Uph Self-Funded	$1,659 - $10,922	50%
Cigna	$2,026 - $3,039	61%
Security Health Plan	$2,171 - $3,256	65%
Mercy Care	$2,533 - $3,799	76%

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 $7,236.
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 Unitypoint Health - Meriter 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.