Knee arthroscopy at Samaritan North Lincoln Hospital. CPT 29881.
What Samaritan North Lincoln Hospital publishes for this service, straight from its standard-charges file, last updated January 31, 2026.
Outpatient / ER
$1,804cash price (self-pay)
$2,255list price
$459–$1,804range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Health | Medicare Advantage - Midlevel - Fac | $526 |
| Devoted Health | Medicare Advantage - Midlevel - Nonfac | $526 |
| Healthnet | Medicare Advantage - Midlevel - Nonfac | $526 |
| Healthnet | Medicare Advantage - Midlevel - Fac | $526 |
| Humana | Medicare Advantage - Midlevel - Nonfac | $526 |
| Humana | Medicare Advantage - Midlevel - Fac | $526 |
| Ihn | Medicaid - Specialty Care | $578 |
| IHN | Medicaid BH Other | $590 |
| Ihn | Medicaid - Primary Care | $590 |
| DEVOTED HEALTH | Medicare Advantage-FAC | $596 |
| DEVOTED HEALTH | Medicare Advantage-NONFAC | $596 |
| Healthnet | Medicare Advantage - Fac | $619 |
| Healthnet | Medicare Advantage - Nonfac | $619 |
| Humana | Medicare Advantage - Nonfac | $619 |
| Humana | Medicare Advantage - Fac | $619 |
| MODA | BH - Licensed Psych NONFAC | $648 |
| MODA | BH - Licensed Psych FAC | $648 |
| Cigna | Nonfacility | $776 |
| Cigna | Facility | $776 |
| Pacificsource | Ml6 - Fac | $832 |
| Aetna | Nonfac - Midlevel Lcsw/Lpc/Rdn | $900 |
| Aetna | Fac - Midlevel Lcsw/Lpc/Rdn | $900 |
| Aetna | Fac - Optometrists - Pyschologists- Pt-St-Ot | $1,020 |
| Aetna | Nonfac - Midlevel Np-Pa-Cnm | $1,020 |
| Aetna | Nonfac - Optometrists - Pyschologists- Pt-St-Ot | $1,020 |
| Aetna | Fac - Midlevel Np-Pa-Cnm | $1,020 |
| Healthnet | Facility | $1,145 |
| Healthnet | Nonfacility | $1,145 |
| Aetna | Fac - Md-Do | $1,200 |
| Aetna | Nonfac - Md-Do | $1,200 |
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