CMS Price Transparency Data

Bunion correction surgery

Facility: Cass County Memorial Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $519
Cash Discount Price: $1,818
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Cass County Memorial Hospital is $519. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,818. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.16x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$1,818

Average discount available for prompt cash payment at this facility.

Insurance Median

$519

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: $1,818 (54%)

Insurance Median: $519 (16%)

Cash: $1,818 (54% of Medicare)

Ins. Median: $519 (16% 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
Triwest - All Plans	$438	13%
Aetna	$452 - $2,337	14%
Amerigroup Mcr Adv - All Other Plans	$452	14%
Medica Mcr Adv	$452	14%
Tricare	$452	14%
UnitedHealthcare	$452 - $799	14%
Va Ccn - All Plans	$452	14%
Wellmark Mcr Adv	$456	14%
Iowa Total Care Mcr	$461	14%
American Hlth Mcr Adv - All Plans	$465	14%
Iowa Total Care Comm - All Other Plans	$497	15%
Midlands Choice Medica Mcr	$519	16%
Wellmark Hmo	$1,008	30%
Wellmark Ppo - All Other Plans	$1,186	35%
Midlands Choice New Bus	$1,210	36%
Midlands Choice Pho (Ppo) - All Other Plans	$1,210	36%
Medica Comm - All Other Plans	$2,285	68%
Multiplan - All Plans	$2,467	74%
Medicaid / KanCare	$2,597	78%
Iowa Total Care Mcaid	$2,649	79%
Molina Mcaid - All Plans	$2,649	79%

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 $1,818.
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 Cass 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.