Knee arthroscopy at Samuel Mahelona Memorial Hospital. CPT 29881.
What Samuel Mahelona Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 15, 2026.
Outpatient / ER
$2,960cash price (self-pay)
$4,554list price
$181–$3,871range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Hawaii Medical Service Association | Medicare | $247 |
| Kaiser Permanente | Medicare | $247 |
| UnitedHealthcare | Medicare | $247 |
| Kaiser Permanente | Commercial | $256 |
| Hawaii Medical Service Association | ABD | $434 |
| Hawaii Medical Service Association | Non-ABD | $434 |
| Kaiser Permanente | Medicaid | $434 |
| UnitedHealthcare | Medicaid | $434 |
| AlohaCare | Medicare | $529 |
| Ohana Health Plan | Medicare | $529 |
| AlohaCare | Medicaid | $569 |
| Ohana Health Plan | Medicaid | $569 |
| Devoted Health | Medicare | $582 |
| Hawaii Western Management Group | Commercial | $659 |
| Health Management Network | Commercial | $3,871 |
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