Knee arthroscopy at Dominican Hospital. CPT 29881.
What Dominican Hospital publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$790–$27,018range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS - Anthem | Medicaid|All Plans | $790 |
| COSC Psych | Medicaid|All Plans | $790 |
| Central California Alliance for Health | Medicaid|All Plans | $790 |
| Health Net | Medicaid|< 21 | $1,196 |
| Health Net | Medicaid|> 21 | $1,196 |
| Blue Shield CA | Medicare|All Plans | $4,458 |
| Health Net | Medicare|All Plans | $4,458 |
| Kaiser | Medicare|All Plans | $4,458 |
| United | Medicare|All Plans | $4,458 |
| Blue Shield CA | Commercial|DHMF | $5,082 |
| Health Net | Commercial|Care Product | $11,420 |
| BCBS - Anthem | Commercial|All Other Plans | $11,746 |
| Blue Shield CA | Commercial|Exchange | $11,908 |
| Blue Shield CA | Commercial|ACO Trio | $12,446 |
| Sutter Health | Commercial|All Plans | $13,952 |
| Blue Shield CA | Commercial|All Other Plans | $15,214 |
| BCBS - Anthem | Commercial|MCS | $16,409 |
| Aetna | Commercial|HMO | $26,811 |
| Aetna | Commercial|PPO | $27,018 |
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