Knee arthroscopy at Good Samaritan Hospital. CPT 29881.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated June 29, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$4,064–$14,440range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Beacon Medicare | Beacon Medicare | $4,064 |
| Hamaspik (Mcr) | Hamaspik (Mcr) | $4,064 |
| Medicare Managed | Medicare Managed | $4,064 |
| Mvp Gold (Mcr) | Mvp Gold (Mcr) | $4,064 |
| World Trade Center Fdny | World Trade Center Fdny | $4,064 |
| World Trade Center Other | World Trade Center Other | $4,064 |
| Medicare | Medicare | $4,084 |
| Emblem Ghi/Hip Medicare | Emblem Ghi/Hip Medicare | $4,146 |
| Affinity By Molina Mcr | Affinity By Molina Mcr | $4,268 |
| Health First Medicare | Health First Medicare | $4,349 |
| Beacon Exchange | Beacon Exchange | $4,877 |
| Beacon Commercial | Beacon Commercial | $5,284 |
| Tricare | Tricare | $6,586 |
| Cigna PPO | Cigna PPO | $7,268 |
| Oxford Commercial | Oxford Commercial | $7,289 |
| Oxford Exchange | Oxford Exchange | $7,411 |
| UHC Exchange | UHC Exchange | $7,411 |
| UHC Commercial | UHC Commercial | $8,719 |
| UHC Empire | UHC Empire | $8,719 |
| Magnacare Preferred | Magnacare Preferred | $8,760 |
| Aetna HP Network | Aetna HP Network | $9,869 |
| Blue Cross Connection/Exchange | Blue Cross Connection/Exchange | $10,414 |
| Aetna | Aetna | $10,965 |
| Aetna Employee | Aetna Employee | $10,965 |
| Mvp Exchange | Mvp Exchange | $12,212 |
| Blue Cross Small Group | Blue Cross Small Group | $12,497 |
| Blue Cross HMO | Blue Cross HMO | $12,827 |
| Geisinger Health Commercial/Exchange | Geisinger Health Commercial/Exc | $13,412 |
| Mvp HMO/PPO | Mvp HMO/PPO | $14,367 |
| Self-Pay | Self-Pay | $14,440 |
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