CMS Price Transparency Data

Bunion correction surgery

Facility: Boone County Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $780
Cash Discount Price: $1,623
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Boone County Hospital is $780. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,623. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.23x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$1,623

Average discount available for prompt cash payment at this facility.

Insurance Median

$780

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: $1,623 (49%)

Insurance Median: $780 (23%)

Cash: $1,623 (49% of Medicare)

Ins. Median: $780 (23% 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
Choice Care Mcr Adv - All Plans	$452	14%
Humana	$452 - $1,826	14%
Iowa Hlth Adv - All Plans	$452	14%
Mt Carmel Hp - All Plans	$452	14%
Va Ccn-All Plans	$452	14%
Amerigroup Mcr Adv - All Other Plans	$456	14%
Aetna	$461 - $875	14%
UnitedHealthcare	$487 - $749	15%
Healthsmart Accell Network	$520	16%
Health Alliance-All Plans	$542	16%
Healthsmart Ppo - All Other Plans	$542	16%
Tricare	$812	24%
Medical Associates Hp-All Plans	$858	26%
Wellmark Hmo	$972	29%
Health Partners Profee Only - All Plans	$1,058	32%
Midlands Choice-All Plans	$1,093	33%
Wellmark Ppo - All Other Plans	$1,140	34%
Mutually Preferred-All Plans	$1,928	58%
Meridian Mcaid - All Plans	$2,029	61%
Iowa Total Care Mcaid - All Plans	$2,070	62%
Medicaid / KanCare	$2,090	63%

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 $1,623.
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 Boone 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.