CMS Price Transparency Data

Bunion correction surgery

Facility: Lost Rivers Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $2,209
  • Cash Discount Price: $3,599
  • vs. Medicare Baseline: 0.66x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Lost Rivers Medical Center is $2,209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,599. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.66x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.
Cash / Self-Pay
$3,599

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,209

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: $3,599 (108%)
Insurance Median: $2,209 (66%)
Cash: $3,599 (108% of Medicare)
Ins. Median: $2,209 (66% 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.

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
Tricare $409 - $3,755 12%
Va Pccc-All Plans $441 - $6,292 13%
Aetna $455 - $6,226 14%
Humana $455 - $6,623 14%
Ihcn Brightpath Mcr Adv $455 - $4,172 14%
Molina Mcr Adv-All Plans $455 - $4,172 14%
Pacificsource Mcr Adv $455 - $4,172 14%
Prime Health Svcs-All Other Plans $455 14%
Prime Hlth Mcr Adv $455 - $4,381 14%
Regence/Brightpth Slhp Mcr $455 - $4,172 14%
Select Health Mcr Adv $455 - $4,172 14%
UnitedHealthcare $455 - $6,292 14%
Blue Cross Blue Shield $523 - $6,623 16%
Provider Network Of America-All Plans $819 - $6,017 24%
Regence Blue Shield-All Other Plans $1,035 - $6,491 31%
Select Health Brightpath-All Other Plans $1,126 - $3,755 34%
Cigna $1,188 - $6,159 36%
Altius Health Plan-All Plans $2,019 - $6,424 60%
First Choice-All Plans $2,209 - $6,159 66%
Ihcn Brightpath-All Other Plans $3,964 119%
Pacificsource Navigator-All Other Plans $6,292 188%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 551 Highland Drive, Arco, ID 83213
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals