CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Charleston Area Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $626
Cash Discount Price: $7,459
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Charleston Area Medical Center is $626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,459. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.19x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$7,459

Average discount available for prompt cash payment at this facility.

Insurance Median

$626

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: $7,459 (223%)

Insurance Median: $626 (19%)

Cash: $7,459 (223% of Medicare)

Ins. Median: $626 (19% 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
Aetna	$411 - $528	12%
The Health Plan Of West Virginia Inc.	$411 - $808	12%
Unicare Health Plan Of West Virginia Inc.	$411	12%
Triwest Va	$490	15%
Blue Cross Blue Shield	$505 - $864	15%
Choicecare Network	$505 - $626	15%
Optimum Choice Inc.	$505	15%
UnitedHealthcare	$505 - $520	15%
West Virginia Senior Advantage Inc.	$530	16%
City Of Charleston	$656	20%
Naphcare	$691	21%
Integrated Medical Solutions	$732	22%
Caresource	$757	23%
Tricare	$876	26%
Three Rivers Providers Network	$1,416	42%
Healthsmart	$1,431	43%
Multiplan	$1,431	43%
Cigna	$1,445	43%

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 $7,459.
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 Charleston Area Medical Center 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.