CMS Price Transparency Data

Bunion correction surgery

Facility: Marinhealth Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $19,968
Cash Discount Price: $28,211
vs. Medicare Baseline: 5.97x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Marinhealth Medical Center is $19,968. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28,211. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 5.97x the Medicare baseline. Located in 250 Bon Air Road, Greenbrae, CA.

Cash / Self-Pay

$28,211

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,968

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3,342.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3,342.87 (100%)

Cash / Self-Pay: $28,211 (844%)

Insurance Median: $19,968 (597%)

Cash: $28,211 (844% of Medicare)

Ins. Median: $19,968 (597% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3,342.87 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 597% of the Medicare baseline (a markup of 497%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$2,330	70%
Aetna	$4,618 - $15,623	138%
Brown And Tolan	$4,618	138%
Healthnet Tailored Network	$4,618	138%
Kaiser	$4,618	138%
Marin Cancer Care	$4,618	138%
Ca Prison Health Care Services	$7,389	221%
Healthnet Enhancedcare	$12,007	359%
Cigna	$13,466	403%
Blue Cross Blue Shield	$17,999 - $22,758	538%
Provider Network Of America	$21,937	656%
Canopy	$26,555	794%
Canopy Hill Physicians	$26,555	794%
Blue Shield Cpic/Epo	$27,391	819%
Providers Network Of America	$29,095	870%
Blue Shield Hmo/Ppo	$30,434	910%
Hills Blue Shield Hmo/Ppo	$30,434	910%
Healthnet Hmo/Ppo	$30,804	921%
Healthnet Hmo/Ppo Hill Physicians	$30,804	921%
Blue Shield Aco	$31,547	944%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $28,211.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 28296.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Marinhealth Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 28296.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.