CMS Price Transparency Data

Bunion correction surgery

Facility: Davis County Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $474
Cash Discount Price: $1,618
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Davis County Hospital is $474. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,618. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.14x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.

Cash / Self-Pay

$1,618

Average discount available for prompt cash payment at this facility.

Insurance Median

$474

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: $1,618 (48%)

Insurance Median: $474 (14%)

Cash: $1,618 (48% of Medicare)

Ins. Median: $474 (14% 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	$452	14%
Choicecare Mcr Adv	$452	14%
Home State Hlth Exch - All Other Plans	$452	14%
Home State Hlth Mcr	$452	14%
Tricare	$452	14%
Amerigroup Mcr Adv-All Other Plans	$461	14%
American Hp Mcr Adv-All Plans	$474	14%
Mt Carmel Hp-All Plans	$474	14%
Choicecare Comm - All Other Plans	$678	20%
Preferred Hlth Choices - All Plans	$858	26%
Blue Cross Blue Shield	$977 - $1,149	29%
Home State Hlth Mcaid	$1,618	48%
Iowa Total Care Mcaid-All Plans	$1,650	49%
Molina Mcaid-All Plans	$1,658	50%
Amerigroup Mcaid	$1,667	50%

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 $1,618.
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 Davis County 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.