Knee arthroscopy at Providence Little Co of Mary Med Center San Pedro. CPT 29881.
What Providence Little Co of Mary Med Center San Pedro publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$2,160–$20,717range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Shield | Medicare Managed Care Plan | $2,160 |
| Aetna | Medicare Managed Care Plan | $4,208 |
| Humana | Medicare Managed Care Plan | $4,293 |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $4,409 |
| Caremore | Medicare Managed Care Plan | $4,629 |
| Blue Shield | Epn/Ifp Benefit Exchange | $4,962 |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $4,966 |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $5,407 |
| La Care Health Plan | Covered Ca Exchange | $5,471 |
| Blue Shield | Hmo | $5,823 |
| Blue Shield | Ppo/Epo | $6,001 |
| Blue Cross | All Commercial Plans | $6,020 |
| Unitedhealthcare | Select/Navigate Hmo | $6,580 |
| Healthnet | Blue And Gold Other Commercial Plan | $7,332 |
| Unitedhealthcare | All Commercial Plans | $7,451 |
| Healthnet | Ambetter Hmo | $7,785 |
| Healthnet | Ambetter Ppo | $9,006 |
| Cigna | Oa/Oap Hmo/Pos | $9,636 |
| Healthnet | All Commercial Plans | $11,827 |
| Cigna | Ppo | $20,717 |
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All common services at Providence Little Co of Mary Med Center San Pedro