Knee arthroscopy at Intermountain Health Garfield Memorial Hospital. CPT 29881.
What Intermountain Health Garfield Memorial Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$90.00–$6,225range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Aetna Medicare HMO | $577 |
| Aetna | Aetna Medicare PPO | $577 |
| Health Choice Utah | Health Choice Utah-Medicaid | $577 |
| Healthy U | Medicaid | $577 |
| Medicare Intermountain Healthcare Nevada | Medicare Intermountain Heal | $577 |
| Molina Healthcare of Utah | Molina Healthcare Medicaid HMO | $577 |
| Molina Healthcare of Utah | Molina Medicare Complete Care HMO SNP | $577 |
| Molina | Medicaid | $577 |
| SelectHealth | Medicaid | $577 |
| SelectHealth | Medicare Advantage | $577 |
| SelectHealth | SelectHealth Community Care-Medicaid | $577 |
| TriWest | Veterans Choice | $577 |
| UofU | Healthy U - Medicaid | $577 |
| Aetna | Aetna Standard Network AKA Aetna Health Plan Network for Utah | $6,225 |
| Aetna | Aetna Utah Connected Network | $6,225 |
| Aetna | Aetna Whole Health Connected Utah Network | $6,225 |
| BYU Athletic Department | Athletic Services | $6,225 |
| Campbell Scientific | Samera Health | $6,225 |
| Cigna Healthcare | CIGNA Managed Care (HMO or Open Access Plus aka OAP | $6,225 |
| Cigna | PPO/EPO | $6,225 |
| Deseret Mutual | DMBA | $6,225 |
| EMI Health | EMI Health | $6,225 |
| EMI Health | EMI Health Choice | $6,225 |
| EMI Health | EMI Health Network Care | $6,225 |
| EMI Health | Mint | $6,225 |
| Franklin County | Samera Health | $6,225 |
| Health Utah | MotivHealth Health Utah | $6,225 |
| Juniper Systems | Samera Health | $6,225 |
| LW Miller | Samera Health | $6,225 |
| Managed Care Administrators, Inc. | Managed Care Administrators, Inc. | $6,225 |
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All common services at Intermountain Health Garfield Memorial Hospital