CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Stoughton Hospital

Billing Code: 29881 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$1,590

about 0.5× the $3,343 Medicare rate · typically $594–$6,829

modeled estimate · not a bill or quote

What this hospital charges insurers

$594

Below the fair price — a good deal

about $996 under the fair price · 0.2× Medicare

Medicare pays $3,343 Fair price $1,590 This hospital $594 Cash price $4,193 Hospital's list price $7,623

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

A typical price — 3 charge more and 5 charge less, among the 9 WI hospitals compared.

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 $1,590 (about 0.5× the $3,343 Medicare rate). Stoughton Hospital charges insurers about $594, or about $4,193 in cash — below the fair price — a good deal. Located in Stoughton, 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	$473 - $6,099	14%
Blue Cross Blue Shieldmajor	$1,036	31%
Aetnamajor	$473 - $5,946	14%
Cignamajor	$6,099	182%
Humanamajor	$594 - $6,861	18%
Dean Health Plan	$473 - $1,590	14%
GEHA	$5,717	171%
Health Net	$402	12%
Quartz	$473 - $1,092	14%
+ 2 smaller / regional plans	$1,520 - $1,751

Government programs also on file: Medicaid, Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 4,193), 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 Stoughton 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 Stoughton Hospital

Compare: Knee arthroscopy with meniscus repair at other WI hospitals

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