CMS Price Transparency Data

Bunion correction surgery

Facility: Adair County Memorial Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $5,851
Cash Discount Price: $8,447
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Adair County Memorial Hospital is $5,851. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,447. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.75x the Medicare baseline. Located in 609 Se Kent, Greenfield, IA.

Cash / Self-Pay

$8,447

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,851

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: $8,447 (253%)

Insurance Median: $5,851 (175%)

Cash: $8,447 (253% of Medicare)

Ins. Median: $5,851 (175% 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
UnitedHealthcare	$452 - $17,128	14%
Aetna	$725 - $13,916	22%
Centivo-All Plans	$813 - $17,984	24%
Mahp-All Plans	$858 - $16,058	26%
Wellmark Hmo	$1,011 - $10,513	30%
Geha-All Plans	$1,059 - $20,340	32%
Midlands Choice-All Plans	$1,069 - $20,768	32%
Iowa Total Care-All Plans	$1,137 - $12,448	34%
Wellmark Ppo - All Other Plans	$1,189 - $10,513	36%

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 $8,447.
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 Adair County Memorial 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.