Bunion correction surgery
Facility: Pratt Regional Medical Center
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $1,423
- Cash Discount Price: $749
- vs. Medicare Baseline: 0.43x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christian Health Aid | $323 - $1,283 | 10% |
| UnitedHealthcare | $358 - $3,300 | 11% |
| Health Partners Of Kansas | $366 - $1,454 | 11% |
| Aetna | $387 - $1,539 | 12% |
| Choicecare | $430 - $1,710 | 13% |
| Celtic Insurance Company | $3,000 | 90% |
| Healthy Blue | $3,090 | 92% |
Consumer Guidance & Cost Commentary
For the bunion correction surgery (CPT 28296) at Pratt Regional Medical Center in Pratt, KS, the cash median price is $749.00, which is significantly lower than the facility's gross charge of $1,070.00. While the facility offers a negotiated rate of $1,423.00 for in-network patients, this amount exceeds the cash price, meaning patients with high-deductible plans or those without insurance could save money by paying cash upfront. It is important to note that the facility's negotiated rates for this procedure range widely among payers, from $323 with Christian Health Aid to $3,090 with Celtic Insurance Company and Healthy Blue, reflecting the variability in commercial contracts.
When comparing pricing benchmarks, the Medicare amount for this service is $3,342.87, and the facility's cash rate of $749.00 represents a substantial discount relative to this federal baseline. Although the data does not provide specific county or state average figures for this procedure, the facility's cash price remains well below the Medicare benchmark, illustrating the potential for significant savings when bypassing insurance administrative costs. Patients should verify their specific plan details before scheduling, as some insurers may have different allowed amounts, and they should explicitly request a "self-pay" or "prompt-pay" discount prior to check-in to ensure they receive the lowest possible rate.