CMS Price Transparency Data

Bunion correction surgery

Facility: St Joseph Health System, LLC

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $1,405
  • Cash Discount Price: $772
  • vs. Medicare Baseline: 0.42x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at St Joseph Health System, LLC is $1,405. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $772. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.42x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$772

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,405

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: $772 (23%)
Insurance Median: $1,405 (42%)
Cash: $772 (23% of Medicare)
Ins. Median: $1,405 (42% 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 Aid $337 - $9,290 10%
Self Pay $337 - $9,290 10%
Php $351 - $15,468 10%
Lutheran Preferred $400 - $23,225 12%
Php Freedom Network $440 - $12,131 13%
Cigna $453 - $38,708 14%
Blue Cross Blue Shield $509 - $14,226 15%
Lutheran Network $631 - $21,289 19%
Three Rivers $631 - $1,307 19%
Aetna $645 - $26,321 19%
Encore Ppo $717 - $34,837 21%
Sagamore $732 - $20,941 22%
Veterans Eval Services $794 24%
Multiplan $968 - $30,192 29%
First Health $1,052 - $29,031 31%
Prime Health Services $1,052 - $29,031 31%
Align Network $1,122 - $30,966 34%
Frontpath Health Coalition $1,122 - $30,966 34%
Advantage Health Solutions $1,164 - $32,127 35%
Allied Benefit Systems $1,263 - $34,837 38%
Medical Mutual Of Ohio $1,403 - $38,708 42%
Parkview Healthplan Services $1,403 - $38,708 42%
Value Options $1,403 - $38,708 42%
Caresource $1,905 57%
Humana $1,905 - $3,406 57%
Managed Health Services $1,905 - $6,924 57%
Medicaid / KanCare $1,905 57%
UnitedHealthcare $1,905 - $9,100 57%
Tricare $3,289 98%
Medicare (plans) $3,406 102%
Department Of Veterans Affairs $3,462 104%
Node Hospice Non Par Agree $3,462 104%
Node Va $3,462 104%
Node Devoted Health Mcr Adv $3,475 104%
In Dept Of Correction $3,600 108%
Node Pphp Mcr Adv $3,635 109%
Us Department Of Labor $4,327 129%
Lutheran Advanced Network $5,193 155%
Encore Work Comp In $6,231 186%
Work Comp $6,924 207%
Encore Kba Epo $8,308 249%
Encore Kba Ppo $10,385 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals