Knee arthroscopy at Holy Cross Hospital - Davis. CPT 29881.
What Holy Cross Hospital - Davis publishes for this service, straight from its standard-charges file, last updated February 11, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$440–$5,944range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Managed Medicaid | Managed Medicaid | $440 |
| UUHP | Managed Medicaid | $440 |
| Humana | Managed Medicare | $507 |
| Managed Medicare | Managed Medicare | $507 |
| Medicare | Medicare | $507 |
| Employer Direct Healthcare | Commercial PPO/POS/HMO | $636 |
| MotivHealth | Commercial PPO/POS/HMO | $672 |
| Molina | Commercial PPO/POS/HMO | $1,114 |
| Regence Blue Cross Blue Shield | Commercial PAR | $3,084 |
| Regence Blue Cross Blue Shield | Commercial PPO | $3,084 |
| Regence Blue Cross Blue Shield | Commercial Savewell | $3,084 |
| Regence Blue Cross Blue Shield | Commercial UVU | $3,084 |
| PEHP | Commercial Summit Exclusive | $5,944 |
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