CMS Price Transparency Data

Bunion correction surgery

Facility: Northside Hospital Cherokee

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $5,756
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.72x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Northside Hospital Cherokee is $5,756. 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 1.72x the Medicare baseline. Located in 450 Northside Cherokee Boulevard, Canton, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,756

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: $5,756 (172%)
Ins. Median: $5,756 (172% 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.

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
One Call Diagnostics $2,187 65%
Ambetter / Centene $2,658 - $9,594 80%
Mti $2,734 82%
Homelink $2,905 87%
Blue Cross Blue Shield $3,270 - $34,850 98%
Clear Springs Eon Health $3,270 98%
Medicare (plans) $3,270 - $3,988 98%
UnitedHealthcare $3,270 - $8,836 98%
Va Ccn $3,270 98%
Humana $3,303 - $3,401 99%
Bccp $3,323 99%
Cbww $3,323 99%
Truths Community $3,323 99%
Aetna $3,336 - $7,421 100%
Coventry $3,336 - $30,000 100%
Caresource $3,368 - $18,600 101%
Kaiser $3,368 - $6,053 101%
Wellcare $3,368 101%
Clover Health $3,433 103%
Pruitt Health Premier $3,434 103%
Lantern $3,622 108%
Fairly Group $3,759 112%
Us Dept Of Labor Wc $4,154 124%
Tricare $5,440 163%
Amerigroup $5,588 - $7,419 167%
Medicaid / KanCare $5,588 - $6,427 167%
Genex/Priority Care Solutions $6,374 191%
Spreemo $6,374 191%
Cigna $6,689 - $7,491 200%
Authentic 4D $7,170 214%
Streamline Imaging $7,170 214%
Oscar $7,706 231%
Corvel Workers Comp $7,967 238%
Employers Choice Network $7,967 238%
Fieldale Farms Wc $7,967 238%
Georgia Workers Compensation $7,967 238%
Northside Health Network $8,102 242%
Health One Alliance_Ppo $12,000 359%
Quick Trip $27,500 823%
Novanet_Ppo $35,000 1047%
Phcs $37,500 1122%
Champus Va $50,000 1496%
Cherokee County Board Of Health $50,000 1496%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Northside Cherokee Boulevard, Canton, GA 30115
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals