CMS Price Transparency Data

Bunion correction surgery

Facility: Saint Mary's Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $9,744
  • Cash Discount Price: $18,823
  • vs. Medicare Baseline: 2.91x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Saint Mary's Hospital is $9,744. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,823. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.91x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$18,823

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,744

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: $18,823 (563%)
Insurance Median: $9,744 (291%)
Cash: $18,823 (563% of Medicare)
Ins. Median: $9,744 (291% 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 291% of the Medicare baseline (a markup of 191%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Connecticut Dept of Correction $3,623 108%
Aetna $3,844 115%
Blue Cross Blue Shield $3,844 - $11,634 115%
Medicare (plans) $3,844 - $4,001 115%
UnitedHealthcare $3,844 115%
Cca Senior Care Options $3,921 117%
Cigna $3,959 118%
Centivo $7,845 235%
Claimdoc $8,237 246%
Diversified Administrators $8,237 246%
Innovative Health Plan II $8,237 246%
Bcn Domestic $11,634 348%
Blue Benefit Administrators of Massachusetts $11,634 348%
Blue Care Network $11,634 348%
Blue Distinction Transplant $11,634 348%
Blue Shield - Ca $11,634 348%
Blue Shield - Id (Regence) $11,634 348%
Blue Shield - Ny Highmark Northeastern $11,634 348%
Blue Shield - Ny Highmark Western $11,634 348%
Blue Shield - PA (Highmark) $11,634 348%
Blue Shield - Wa (Regence) $11,634 348%
Health Choices $11,634 348%
Kaiser Domestic $11,634 348%
Pre-Employment $11,634 348%
Unicare $11,634 348%
Wc Domestic $11,634 348%
Wellpoint $11,634 348%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals