CMS Price Transparency Data

Knee arthroscopy with meniscus repair

Facility: St Francis Hospital

Billing Code: 29881 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 29881
Insurance Median: $7,223
Cash Discount Price: $7,008
vs. Medicare Baseline: 2.16x Medicare

The contracted insurance negotiated median rate for a Knee arthroscopy with meniscus repair at St Francis Hospital is $7,223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,008. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.16x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$7,008

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,223

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: $7,008 (210%)

Insurance Median: $7,223 (216%)

Cash: $7,008 (210% of Medicare)

Ins. Median: $7,223 (216% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 216% of the Medicare baseline (a markup of 116%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$2,044 - $2,239	61%
Humana	$2,044	61%
Clear Spring Health of Illinois	$2,044	61%
UnitedHealthcare	$2,141 - $9,734	64%
Aetna	$2,141 - $6,843	64%
Molina Healthcare	$2,146 - $4,180	64%
Wexford	$2,654 - $3,981	79%
Amish Community	$2,726	82%
Meridian Health Plan	$2,920 - $4,379	87%
Celtic Insurance Company	$4,925	147%
Claim Doc	$5,110	153%
Hopetrust	$5,597	167%
Wellfirst	$6,262	187%
First Health	$7,223	216%
Cigna	$7,787	233%
Caterpillar, Inc.	$7,807	234%
Current Health Solutions	$8,177	245%
Multiplan/Phcs	$8,274	248%
Consociate Group	$8,274	248%
Healthlink	$8,303	248%
Provider Network of America	$8,761	262%
Healthcare Finest Network (Hfn)	$8,761	262%
Healthscope	$9,734	291%
Live360	$9,734	291%
Naphcare	$9,734	291%
Health Alliance Medical Plans	$9,734	291%
Illinois Breast and Cervical Cancer Program	$9,734	291%
Interplan	$9,734	291%

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 $7,008.
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 St Francis Hospital 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.