Bunion correction surgery
Facility: Wesley Medical Center
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $2,689
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.80x 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 |
|---|---|---|
| Usa Managed Care | $815 | 24% |
| UnitedHealthcare | $1,049 | 31% |
| Medicaid / KanCare | $1,080 | 32% |
| Amerigroup | $1,091 | 33% |
| Aetna | $1,091 - $3,283 | 33% |
| Blue Cross Blue Shield | $2,689 | 80% |
| First Health | $5,026 | 150% |
| Multiplan | $5,237 | 157% |
| United | $5,766 | 172% |
Consumer Guidance & Cost Commentary
For CPT code 28296, bunion correction surgery, at Wesley Medical Center in Wichita, KS, the facility's negotiated rate of $2,689.00 is significantly lower than the highest commercial rates observed, such as First Health's $5,026 and Multiplan's $5,237, though it remains higher than the lowest rates from plans like USA Managed Care at $815. The facility's negotiated rate is also 80% of the Medicare amount of $3,342.87, indicating a pricing structure that aligns closely with federal benchmarks rather than the inflated chargemaster lists often used for comparison. While the facility's cash and median paid rates are not currently disclosed, patients with high-deductible plans should be aware that paying cash upfront could potentially result in lower costs if the insurance negotiated rate exceeds the cash price, making it essential to inquire directly about self-pay or prompt-pay discounts before scheduling.
The pricing data reflects a diverse range of payer contracts, with rates varying from $815 to $5,766 across nine different payers, highlighting how network tiering and administrative costs can drastically alter out-of-pocket expenses. Although specific county or state average comparisons for this procedure are not provided in the current dataset, the wide variance in allowed amounts underscores the importance of verifying the specific allowed amount for your plan rather than assuming in-network status guarantees the lowest price. To ensure you are not overcharged, we recommend requesting a full itemized bill that breaks down every CPT code and unit cost, as summary bills often obscure errors or unbundled charges. Additionally, if you encounter a balance bill for services not covered by