Knee arthroscopy at Mount St. Mary's Hospital. CPT 29881.
What Mount St. Mary's Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,869cash price (self-pay)
$1,869list price
$112–$890range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup [350102] | Chp BCBS Amg Non Mcd [35010202] | $154 |
| Medicaid HMO Other Nys [350104] | Medicaid HMO Other Nys [35010401] | $154 |
| Medicaid Out Of State [309999] | Medicaid California [30999904] | $154 |
| Medicaid Out Of State [309999] | Medicaid Florida [30999905] | $154 |
| Medicaid Out Of State [309999] | Medicaid Michigan [30999908] | $154 |
| Medicaid Out Of State [309999] | Medicaid New Hampshire [30999911] | $154 |
| Wellpoint Bc Medicaid [351102] | Wellpoint Bc Chp Medicaid [35110202] | $154 |
| United Healthcare Essential [100253] | UHC Essential Plan 200-250 [100 | $171 |
| Molina Medicaid [350107] | Affinity Molina Chp Non-Medicaid [35010704] | $216 |
| Molina Medicaid [350107] | Affinity Molina Medicaid [35010705] | $216 |
| Univera Healthcare [100169] | Univera Access [10016908] | $222 |
| United Healthcare Medicare [450021] | UHC Medicare HMO [45002110] | $224 |
| Cigna Medicare HMO [450113] | Cigna Medicare HMO [45011301] | $246 |
| Fidelis Dual Advantage [450120] | Fidelis Dual Advantage [45012001] | $258 |
| Wellcare Fidelis Dual [450451] | Wellcare Fidelis Dual Dsnp [45045103] | $258 |
| Mvp Gold Medicare [450123] | Mvp Gold Medicare [45012301] | $274 |
| Iha First Choice [800001] | Iha Ch First Choice Deductible Plan [80000 | $314 |
| Independent Health [100165] | Commercial Iha 44 [10016501] | $314 |
| Independent Health [100165] | Iha Article 43 [10016502] | $314 |
| Blue Cross/Blue Shield [100151] | Empire B/C PPO-Yls [10015108] | $383 |
| Blue Cross/Blue Shield [100151] | Preferred Choice PPO [10015115] | $383 |
| Blue Cross/Blue Shield [100151] | Blue Cross/Blue Shield [10015101] | $383 |
| Blue Cross/Blue Shield [100151] | Out Of Area Traditional B/C [1001510 | $383 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 1 And 2 | $445 |
| Federal Workers Compensation [500100] | Division Of Federal Employees | $514 |
| Commercial - Other [100172] | Gerber Life Ins [10017202] | $533 |
| Commercial - Other [100172] | Healthsource [10017204] | $533 |
| Humana [100052] | Humana One [10005203] | $533 |
| Beacon Essential [350122] | Beacon Essential Plan 1 And 2 [35012201] | $591 |
| Univera Healthcare [100169] | Traditional [10016904] | $654 |
Inpatient
$1,869cash price (self-pay)
$1,869list price
$112–$890range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS Essential [100152] | Bc Essential Plan 3 And 4 [10015202] | $183 |
| Independent Health Medicaid [350106] | Child Health Plus Iha Medicaid | $250 |
| Medicaid In State [300001] | Medicaid In State [30000101] | $250 |
| Medicaid Out Of State [309999] | Medicaid Arkansas [30999903] | $250 |
| Wellpoint Bc Essential [101152] | Wellpoint Bc Essential Pan 1 And 2 [ | $250 |
| Amerigroup [350102] | BCBS Amerigroup Mcd [35010203] | $250 |
| Crime Victims [100176] | Crime Victims [10017601] | $250 |
| Independent Health Essential [100166] | Iha Essential Plan 1 And 2 [10 | $250 |
| Medicaid In State [300001] | Medicaid Episodic [30000103] | $250 |
| Medicaid In State Alt Payer [300002] | School Medicaid Alt [30000201] | $250 |
| Medicaid Out Of State [309999] | Medicaid Maine [30999907] | $250 |
| Medicaid Out Of State [309999] | Medicaid Pennsylvania [30999912] | $250 |
| Excellus Rochester Mcd [350117] | Excellus Rochester Mcd [35011701] | $250 |
| Vna Option Mltc [350110] | Vna Options [35011001] | $250 |
| BCBS Medicaid [350103] | Bc Ooa Medicaid [35010301] | $250 |
| Independent Health Medicaid [350106] | Medisource [35010601] | $250 |
| Medicaid Out Of State [309999] | Medicaid Out Of State [30999901] | $250 |
| Wellpoint Bc Essential [101152] | Wellpoint Bc Essential Plan 3 And 4 | $250 |
| Amerigroup Medicaid [350002] | Amerigroup Medicaid [35000201] | $250 |
| Medicaid Out Of State [309999] | Medicaid California [30999904] | $250 |
| Medicaid Out Of State [309999] | Medicaid Florida [30999905] | $250 |
| Medicaid Out Of State [309999] | Medicaid Michigan [30999908] | $250 |
| Medicaid Out Of State [309999] | Medicaid New Hampshire [30999911] | $250 |
| Wellpoint Bc Essential [101152] | Wellpoint Bc Essential Plan 200-250 | $250 |
| Amerigroup [350102] | Chp BCBS Amg Non Mcd [35010202] | $250 |
| Excellus Rochester Medicaid [350112] | Excellus Rochester Medicaid [35 | $250 |
| Blue Cross/Blue Shield [100151] | Empire B/C PPO-Yls [10015108] | $294 |
| Blue Cross/Blue Shield [100151] | Empire B/C -Yls [10015107] | $294 |
| Fidelis Essential [100163] | Fidelis Essential Plan 1 And 2 [10016301] | $295 |
| Va Veterans Affairs [700001] | Va [70000101] | $492 |
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