Knee arthroscopy at Dodge County Hospital Authority. CPT 29881.
What Dodge County Hospital Authority publishes for this service, straight from its standard-charges file, last updated May 14, 2026.
Outpatient / ER
—cash price (self-pay)
$5,538list price
$100–$4,984range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS Pathway/HMO | HMO | $100 |
| Peach State Medicaid | HMO | $861 |
| Amerigroup Medicaid | PPO | $984 |
| UHC Commercial | PPO | $1,519 |
| BCBS PPO/Par | PPO | $1,700 |
| Aetna Medicare Advantage | HMO | $2,853 |
| UHC Medicare Advantage | HMO | $2,853 |
| Humana Medicare PPO | PPO | $2,853 |
| Aetna | PPO | $4,153 |
| Cigna | PPO | $4,984 |
Inpatient
—cash price (self-pay)
$5,538list price
$1.00–$2,954range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | PPO | $1.00 |
| UHC Commercial | PPO | $1.00 |
| Peach State Medicaid | HMO | $1.00 |
| BCBS PPO/Par | PPO | $2,298 |
| Amerigroup Medicaid | PPO | $2,954 |
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