CMS Price Transparency Data

Bunion correction surgery

Facility: St Lukes Regional Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,550
Cash Discount Price: $3,404
vs. Medicare Baseline: 0.46x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at St Lukes Regional Medical Center is $1,550. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,404. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.46x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.

Cash / Self-Pay

$3,404

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,550

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: $3,404 (102%)

Insurance Median: $1,550 (46%)

Cash: $3,404 (102% of Medicare)

Ins. Median: $1,550 (46% 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	$476 - $7,932	14%
Blue Cross Blue Shield	$485 - $3,225	15%
Molina	$485 - $3,225	15%
Amerivantage	$499 - $3,320	15%
Humana	$499 - $3,320	15%
UnitedHealthcare	$499 - $8,660	15%
Avera Health Plan	$713 - $2,247	21%
Nebraska Total Care	$738 - $1,475	22%
Wellmark Uph Self-Funded	$1,008	30%
Health Partners Open Network	$1,012 - $4,844	30%
Cigna	$1,262	38%
Amerigroup	$2,874	86%
Iowa Total Care	$2,874	86%

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 $3,404.
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 St Lukes Regional Medical Center 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.