CMS Price Transparency Data

Bunion correction surgery

Facility: Adventist Health Tulare

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $494
Cash Discount Price: $346
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Adventist Health Tulare is $494. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $346. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.15x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$346

Average discount available for prompt cash payment at this facility.

Insurance Median

$494

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: $346 (10%)

Insurance Median: $494 (15%)

Cash: $346 (10% of Medicare)

Ins. Median: $494 (15% 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
Aetna	$463	14%
Blue Shield Mcare	$494	15%
Fhcn Pace Mcr Adv - All Plans	$494	15%
Medicare (plans)	$494	15%
Tricare	$494	15%
UnitedHealthcare	$494 - $675	15%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot	$494	15%
Ah Employee Health Plan - All Plans	$544	16%
Incentive Hlth - All Plans	$544	16%
Hs Interplan-All Plans	$618	18%
Cigna	$640	19%
Cal Forensic Med Grp - All Plans	$643	19%
Healthnet Hmo/Ppo - All Other Plans	$720	22%
Blue Shield Epn	$1,028	31%
Blue Shield-All Other Plans	$1,086	32%
Blue Cross Blue Shield	$1,176	35%

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 $346.
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 Adventist Health Tulare 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.