CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Tomah Memorial Hospital

Billing Code: 29881 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$643

about 0.2× the $3,343 Medicare rate · typically $477–$2,597

modeled estimate · not a bill or quote

What this hospital charges insurers

$544

Below the fair price — a good deal

about $99 under the fair price · 0.2× Medicare

Medicare pays $3,343 Fair price $643 This hospital $544 Cash price $3,260 Hospital's list price $5,669

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Lowest price of the 9 WI hospitals we have prices for — a strong deal.

Cheapest $544 Priciest $1,654

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Knee arthroscopy with meniscus repair is about $643 (about 0.2× the $3,343 Medicare rate). Tomah Memorial Hospital charges insurers about $544, or about $3,260 in cash — below the fair price — a good deal. Located in Tomah, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$402 - $1,125	12%
Blue Cross Blue Shieldmajor	$473 - $1,220	14%
Aetnamajor	$544 - $4,819	16%
Cignamajor	$5,499	164%
Humanamajor	$5,244	157%
Quartz	$473 - $5,102	14%
+ 8 smaller / regional plans	$473 - $4,819

Government programs also on file: Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 3,260), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 29881.

Insurance Before you use insurance

Call your insurance company to confirm Tomah Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 29881.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Tomah Memorial Hospital

Compare: Knee arthroscopy with meniscus repair at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.