CMS Price Transparency Data

Bunion correction surgery

Facility: Desert Valley Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,639
Cash Discount Price: $4,187
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Desert Valley Hospital is $3,639. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,187. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.09x the Medicare baseline. Located in 16850 Bear Valley Rd, Victorville, CA.

Cash / Self-Pay

$4,187

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,639

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: $4,187 (125%)

Insurance Median: $3,639 (109%)

Cash: $4,187 (125% of Medicare)

Ins. Median: $3,639 (109% 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.

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
Blue Shield Of Promise	$575 - $3,639	17%
Heritage Victor Valley Medical Group	$575 - $3,639	17%
High Desert Pace	$575 - $3,639	17%
Molina	$575 - $3,639	17%
Traditional Medi-Cal	$575	17%
Vantage Care	$575 - $3,639	17%
Health Net Of Ca	$615 - $3,639	18%
Inland Empire Health Plan	$833 - $3,639	25%
Aetna	$3,639	109%
Alignment	$3,639	109%
Blue Cross Blue Shield	$3,639	109%
Blue Shield Of Ca	$3,639	109%
Brand New Day	$3,639	109%
Choice Physicians Network	$3,639	109%
Elite Health Plan	$3,639	109%
Employer Direct Healthcare	$3,639	109%
Epic Health Plan	$3,639	109%
High Desert Primary Care	$3,639	109%
Imperial Health Plan Of Ca	$3,639	109%
Inland Empire Foundation For Medical Care	$3,639	109%
Medicare (plans)	$3,639	109%
Naphcare	$3,639	109%
Prime Health Services Inc	$3,639	109%
Renal Payor Solutions	$3,639	109%
The Geo Group Inc	$3,639	109%
Tricare	$3,639	109%
UnitedHealthcare	$3,639	109%
Wellpath	$3,639	109%
Workers Compensation	$3,639	109%

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 $4,187.
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 Desert Valley Hospital 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.