CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Oakleaf Surgical Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $3,241
  • Cash Discount Price: $7,051
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Oakleaf Surgical Hospital is $3,241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,051. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$7,051

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,241

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: $7,051 (211%)
Insurance Median: $3,241 (97%)
Cash: $7,051 (211% of Medicare)
Ins. Median: $3,241 (97% 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
Blue Cross Blue Shield $3,241 - $9,999 97%
Dean Health Plan $3,241 97%
Group Health Cooperative Of Eau Claire $3,241 97%
Healthpartners $3,241 97%
Humana $3,241 97%
Medica $3,241 97%
Quartz Health Solutions $3,241 97%
Security Health Plan Of Wi $3,241 - $5,205 97%
Ucare Wi $3,241 97%
UnitedHealthcare $3,241 97%
Alliance $4,861 145%

Consumer Guidance & Cost Commentary

For this knee arthroscopy with meniscus repair at Oakleaf Surgical Hospital in Altoona, WI, the most significant pricing benchmark is the Medicare rate of $3,342.87, which serves as a scientifically validated baseline for the true cost of care. The facility's cash median price of $7,051 is notably higher than the Medicare amount, while the negotiated rate for in-network insurance plans is $3,241, which aligns closely with the federal benchmark. This data highlights that for patients with high-deductible plans, paying cash upfront might be more cost-effective than relying on insurance, as the cash price here is lower than the negotiated rate paid by most commercial payers.

To further reduce potential costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can provide immediate liquidity incentives that bypass costly claims processing. It is also important to understand that while the facility's gross charge is $7,834, the actual amount billed to an in-network member is capped at the negotiated rate of $3,241, preventing balance billing for this specific procedure under the No Surprises Act. Consumers are advised to request a full itemized billing audit before finalizing any payment to ensure no unbundled codes or services not rendered are included in the final invoice.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals