CMS Price Transparency Data

Bunion correction surgery

Facility: Mc Donough District Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $560
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.17x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Mc Donough District Hospital is $560. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.17x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$560

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%)
Insurance Median: $560 (17%)
Ins. Median: $560 (17% 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
Hfn $122 - $1,146 4%
UnitedHealthcare $122 - $3,622 4%
Aetna $130 - $6,839 4%
Health Alliance $130 - $3,622 4%
Humana $130 - $6,839 4%
Medicaid / KanCare $130 - $6,839 4%
Medicare (plans) $130 - $3,622 4%
Meridian $130 - $3,622 4%
Molina $130 - $1,217 4%
Mutual Medical $130 - $1,217 4%
Veteran Affairs $130 - $3,622 4%
Tricare $3,382 101%
Blue Cross Blue Shield $6,839 205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals