CMS Price Transparency Data

Bunion correction surgery

Facility: HCA Florida Palms West Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $6,802
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at HCA Florida Palms West Hospital is $6,802. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.03x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,802

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%)

Insurance Median: $6,802 (203%)

Ins. Median: $6,802 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
Optimum	$2,350 - $4,575	70%
Corvel Corporation	$2,373 - $5,802	71%
Careworks (Rockport)	$2,423 - $5,924	72%
Prime Health	$2,423 - $5,924	72%
Simply Healthcare Plans	$3,792	113%
Aids Healthcare	$3,950	118%
Molina	$3,950 - $5,211	118%
Health Sun Health Plan	$4,200	126%
Avmed	$4,281 - $9,160	128%
Medica Healthcare	$4,500	135%
Freedom Health	$4,575	137%
Mmm Of Fl (Health Advantage Plan)	$4,750	142%
Sunshine State Health Plan	$4,963	148%
Cigna	$6,802	203%
Simply Healthcare	$7,583	227%
Oscar	$8,392	251%
United	$10,100	302%
Amerihealth Caritas	$11,447	342%
Blue Cross Blue Shield	$13,571 - $18,507	406%

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 $X.
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 HCA Florida Palms West 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.