CMS Price Transparency Data

Bunion correction surgery

Facility: Northside Hospital Duluth

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $6,116
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Northside Hospital Duluth is $6,116. 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 1.83x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,116

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: $6,116 (183%)
Ins. Median: $6,116 (183% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Us Dept Of Labor Wc $828 25%
One Call Diagnostics $2,187 65%
Ambetter / Centene $2,658 - $10,726 80%
Mti $2,734 82%
Homelink $2,905 87%
Blue Cross Blue Shield $3,229 - $34,850 97%
Clear Springs Eon Health $3,229 97%
Medicare (plans) $3,229 - $3,875 97%
UnitedHealthcare $3,229 - $8,836 97%
Va Ccn $3,229 97%
Aetna $3,262 - $7,421 98%
Humana $3,262 - $3,359 98%
Bccp $3,282 98%
Cbww $3,282 98%
Truths Community $3,282 98%
Coventry $3,294 - $30,000 99%
Caresource $3,326 - $18,600 99%
Kaiser $3,326 - $6,053 99%
Wellcare $3,326 99%
Clover Health $3,390 101%
Pruitt Health Premier $3,391 101%
Lantern $3,622 108%
Fairly Group $3,712 111%
Tricare $5,440 163%
Amerigroup $6,316 - $8,978 189%
Institutional Gwinnett County Govt $6,316 - $8,978 189%
Medicaid / KanCare $6,316 - $10,325 189%
Genex/Priority Care Solutions $6,374 191%
Spreemo $6,374 191%
Cigna $6,689 - $8,679 200%
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%
Johnson Ferry Imaging $50,000 1496%
Marietta Dermatology Clinical Research Inc $50,000 1496%
West Paces Imaging Agreement $50,000 1496%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals