Knee arthroscopy at St. Mary Medical Center. CPT 29881.
What St. Mary Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$195cash price (self-pay)
$1,220list price
$14.05–$9,538range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Jefferson Health Plans Medicaid | Health Partners Medicaid | $216 |
| Rx Allwin | Medicare | $264 |
| Molina Medicare Advantage | Medicare | $264 |
| Commonwealth Care Alliance | Medicare | $264 |
| Solis Health Plans | Medicare | $264 |
| Serenity Pace | Medicare | $264 |
| Total Healthcare Medicare Snp | Medicare | $264 |
| Carefirst Medicare Advantage | Medicare | $264 |
| Mercy Life | Medicare | $264 |
| Health Alliance Medicare Advantage | Medicare | $264 |
| Simply Healthcare Medicare Advantage | Medicare | $264 |
| Sunshine Health Medicare Advantage | Medicare | $264 |
| Reliance Community Care Partners Care Resources Pace | Medicare | $264 |
| Medicare Alternate Payor | Medicare | $264 |
| Rx Medicare Part B | Medicare | $264 |
| Universal Medicare | Medicare | $264 |
| Triwest Health Alliance | Tricare | $272 |
| Wellsense Health Plan | Medicaid | $272 |
| Freedom First Healthcare | Medicaid | $272 |
| Medicaid Pending | Medicaid | $272 |
| Mvp Medicaid Advantage | Medicaid | $272 |
| Wellpoint Medicaid | Medicaid | $272 |
| Cigna Medicaid Advantage | Medicaid | $272 |
| Wellcare Medicaid | Medicaid | $272 |
| Nextlevel Health | Medicaid | $272 |
| Health Partners Medicare Advantage | Health Partners Medicare Advantag | $277 |
| Jefferson Health Plans Medicare | Health Partners Medicare Advantage | $277 |
| Devoted Health Medicare Advantage | Devoted Health Medicare Advantage | $277 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $291 |
| Blue Cross - Pa (Independence) Medicare Advantage | Independence Blue | $292 |
Inpatient
$195cash price (self-pay)
$1,220list price
$177–$1,159range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Rx Allwin | Medicare | $264 |
| Molina Medicare Advantage | Medicare | $264 |
| Carecentrix Medicare Advantage | Medicare | $264 |
| Blue Cross - Ct (Anthem) Medicare Advantage | Medicare | $264 |
| Blue Shield - Pa (Highmark) Medicare Advantage | Medicare | $264 |
| Martins Point Generations Advantage | Medicare | $264 |
| Medstar Medicare Advantage | Medicare | $264 |
| Gold Kidney Medicare | Medicare | $264 |
| Alignment Health Plan Medicare Advantage | Medicare | $264 |
| Blue Cross - Ga (Anthem) Medicare Advantage | Medicare | $264 |
| Blue Cross - Ky (Anthem) Medicare Advantage | Medicare | $264 |
| Blue Cross - Ne Medicare Advantage | Medicare | $264 |
| Optimum Healthcare Medicare Advantage | Medicare | $264 |
| Blue Care Network Advantage | Medicare | $264 |
| Priority Health Medicaid | Medicaid | $272 |
| Illinicare Health Medicaid Advantage | Medicaid | $272 |
| Massachusetts Behavioral Health Partnership | Medicaid | $272 |
| Health New England Medicaid Advantage | Medicaid | $272 |
| Green Mountain Medicaid Advantage | Medicaid | $272 |
| Simply Healthcare Medicaid | Medicaid | $272 |
| Fidelis Care Medicaid Advantage | Medicaid | $272 |
| Childrens Medical Services Title 19 | Medicaid | $272 |
| Medicaid - Ar | Medicaid | $272 |
| Medicaid - NY | Medicaid | $272 |
| Medicaid - Nm | Medicaid | $272 |
| Cmh Van Buren County | Medicaid | $272 |
| Cmh Washtenaw County | Medicaid | $272 |
| Jefferson Health Plans Medicare | Health Partners Medicare Advantage | $277 |
| Wc Pma | Workers Comp | $305 |
| Wc Aegis | Workers Comp | $305 |
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