CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: Regional Medical Center

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 29881
  • Insurance Median: $870
  • Cash Discount Price: $4,758
  • vs. Medicare Baseline: 0.26x Medicare
The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at Regional Medical Center is $870. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,758. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.26x the Medicare baseline. Located in 709 W Main Street, Manchester, IA.
Cash / Self-Pay
$4,758

Average discount available for prompt cash payment at this facility.

Insurance Median
$870

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: $4,758 (142%)
Insurance Median: $870 (26%)
Cash: $4,758 (142% of Medicare)
Ins. Median: $870 (26% 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
Medical Associates Health Plan - Tri $870 26%

Consumer Guidance & Cost Commentary

For patients paying cash directly, the most important thing to know is that self-pay rates can sometimes be significantly lower than what insurance companies negotiate, offering a potential savings opportunity if your plan's negotiated rate exceeds the cash price. For this Knee arthroscopy with meniscus repair at Regional Medical Center in Manchester, Iowa, the cash median rate is $4,758, while the median negotiated rate with Medical Associates Health Plan - Tri is $870. Although the cash price appears higher in this specific data point, it is crucial to ask the facility about "self-pay" or "prompt-pay" discounts before scheduling, as hospitals may offer additional reductions for upfront payment that could lower the final amount owed.

The broader pricing context reveals that the facility's gross chargemaster rate for this procedure is $5,948, which serves as the base list price before any discounts are applied. This gross rate is compared against the state average, where the Medicare benchmark rate for this service is $3,342.87, providing a scientifically validated baseline for the true cost of care. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price compared to the Medicare amount.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 709 W Main Street, Manchester, IA 52057
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals