CMS Price Transparency Data

Bunion correction surgery

Facility: Sullivan County Community Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $478
Cash Discount Price: $966
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Sullivan County Community Hospital is $478. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $966. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.14x the Medicare baseline. Located in 2200 N Section St, Sullivan, IN.

Cash / Self-Pay

$966

Average discount available for prompt cash payment at this facility.

Insurance Median

$478

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: $966 (29%)

Insurance Median: $478 (14%)

Cash: $966 (29% of Medicare)

Ins. Median: $478 (14% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$415	12%
Ambetter / Centene	$456	14%
Blue Cross Blue Shield	$456 - $648	14%
Mdwise Mcr Adv	$456	14%
Mhs Hlthy In Mcaid	$456	14%
Va Ccn - All Plans	$456	14%
Humana	$461 - $638	14%
Mdwise Mcaid - All Other Plans	$478	14%
Mhs Mcaid - All Other Plans	$478	14%
Siho - All Plans	$966	29%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $966.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 28296.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sullivan County Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 28296.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.