CMS Price Transparency Data

Bunion correction surgery

Facility: HSHS St Elizabeth's Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $5,018
  • Cash Discount Price: $4,251
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at HSHS St Elizabeth's Hospital is $5,018. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,251. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.50x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$4,251

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,018

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: $4,251 (127%)
Insurance Median: $5,018 (150%)
Cash: $4,251 (127% of Medicare)
Ins. Median: $5,018 (150% 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
Amish Community $1,653 49%
Aetna $3,622 - $4,156 108%
Blue Cross Blue Shield $3,622 - $5,904 108%
Clear Spring Health Of Illinois $3,622 108%
Health Alliance Medical Plans $3,622 - $5,018 108%
Health Partners $3,622 108%
Humana $3,622 108%
Sae Hospice $3,622 108%
UnitedHealthcare $3,622 - $5,904 108%
Molina Healthcare $3,792 - $4,962 113%
Wellfirst $3,801 114%
First Health $4,392 131%
Cigna $4,664 - $5,904 140%
Healthlink $4,693 - $5,904 140%
Caterpillar, Inc. $4,741 142%
Consociate Group $5,195 155%
Meridian Health Plan $5,198 155%
Choicecare $5,313 159%
Healthcare Finest Network (Hfn) $5,313 159%
Multiplan/Phcs $5,313 159%
Provider Network Of America $5,313 159%
Celtic Insurance Company $5,904 177%
City Of Springfield $5,904 177%
Claim Doc $5,904 177%
Current Health Solutions $5,904 177%
Healthscope $5,904 177%
Hopetrust $5,904 177%
Illinois Breast And Cervical Cancer Program $5,904 177%
Interplan $5,904 177%
Live360 $5,904 177%
Wexford $5,904 177%
Naphcare $7,850 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals