CMS Price Transparency Data

Bunion correction surgery

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $1,317
  • Cash Discount Price: $474
  • vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at The Orthopaedic Hospital of Lutheran Health Networ is $1,317. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $474. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.39x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.
Cash / Self-Pay
$474

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,317

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: $474 (14%)
Insurance Median: $1,317 (39%)
Cash: $474 (14% of Medicare)
Ins. Median: $1,317 (39% 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
Physicians Health Plan $335 - $11,337 10%
Amish Aid $379 - $3,778 11%
Self Pay $379 - $7,891 11%
Lutheran Preferred $410 - $17,535 12%
Php Freedom Network $440 - $9,159 13%
Cigna $492 - $29,226 15%
Aetna $547 - $14,174 16%
Three Rivers Preferred $561 - $1,307 17%
Sagamore $675 - $15,811 20%
Encore Ppo $702 - $14,613 21%
One Call Work Comp $839 25%
Multiplan $968 - $22,796 29%
Prime Health Services $1,052 - $21,919 31%
First Health $1,080 - $22,504 32%
Encore $1,122 - $23,380 34%
Medicaid / KanCare $1,466 - $1,905 44%
Blue Cross Blue Shield $1,905 - $14,226 57%
Caresource $1,905 57%
Humana $1,905 - $3,406 57%
Managed Health Services $1,905 - $6,924 57%
Mhs $1,905 57%
UnitedHealthcare $1,905 - $9,154 57%
Tricare $3,289 98%
Iu Health Plan $3,406 102%
Medicare (plans) $3,406 102%
Node Mhs Mcr Adv $3,406 102%
Small Business Aid $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%
Police And Sheriff $3,528 106%
In Dept Of Correction $3,600 108%
Node Pphp Mcr Adv $3,635 109%
Node Us Dept Of Labor $4,327 129%
Lutheran Advanced Network $5,193 155%
Node Lutheran Three Rivers Preferred Plus 150 $5,193 155%
Occunet In Work Comp $5,193 155%
Align Network $5,539 166%
Node Lutheran Three Rivers Preferred Plus 175 $6,058 181%
Encore Wc $6,231 186%
Medrisk In Work Comp $6,231 186%
Three Rivers Preferred In Work Comp $6,231 186%
Objective Surgical $6,751 202%
In Work Comp $6,924 207%
Lutheran Network $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: 7952 W Jefferson Blvd, Ft Wayne, IN 46804
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals