Bunion correction surgery
Facility: Providence Medical Center
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $3,237
- Cash Discount Price: $3,082
- vs. Medicare Baseline: 0.97x 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 |
|---|---|---|
| Aetna | $334 - $3,130 | 10% |
| Medicaid / KanCare | $1,049 | 31% |
| UnitedHealthcare | $1,049 - $6,375 | 31% |
| Celtic | $1,070 - $4,932 | 32% |
| Healthy Blue | $1,070 - $3,237 | 32% |
| Comp Alliance - Fka Compresults Worker Compensation | $1,816 | 54% |
| Midland Care Connection | $3,083 | 92% |
| Cigna | $3,083 | 92% |
| Medicare (plans) | $3,083 | 92% |
| Tricare | $3,083 | 92% |
| Kansas Superior Select | $3,237 | 97% |
| Corizon | $4,007 | 120% |
| Employer Direct Healthcare | $4,316 | 129% |
| Well Path Prison | $4,316 | 129% |
| Centurion | $4,624 | 138% |
| Naphcare | $4,778 | 143% |
| Blue Cross Blue Shield | $4,932 - $5,703 | 148% |
| Oha Networks | $5,132 | 154% |
| Worker Compensation | $5,290 | 158% |
Consumer Guidance & Cost Commentary
For the CPT code 28296, representing bunion correction surgery at Providence Medical Center in Kansas City, KS, the cash median price is $3,082.00, which is significantly lower than the facility's negotiated rates. While the facility's cash price is competitive, commercial payers negotiate rates that range widely, with the lowest allowed amount being $334 for Aetna and the highest reaching $5,703 for Blue Cross Blue Shield. It is important to note that for patients with high-deductible plans, paying the cash price of $3,082.00 upfront may be more cost-effective than relying on insurance, as many commercial negotiated rates exceed the cash price due to administrative overhead and contract structures. Additionally, patients should verify if the facility offers self-pay or prompt-pay discounts, which can further reduce the final amount owed by bypassing the costly insurance claims processing cycle.
The facility's pricing aligns closely with the Medicare benchmark, with a Medicare amount of $3,342.87 and a vs_medicare ratio of 1.0, indicating that the facility charges at the federal baseline for this procedure. This stands in contrast to the gross charge of $11,473.00, which serves as the inflated list price often used to obscure actual costs. While the facility is a voluntary non-profit acute care hospital with a 3-star rating, the wide variation in commercial negotiated rates—spanning from $334 to $5,703 across 19 different payers—highlights the importance of checking specific insurance allowed amounts before scheduling. Consumers are advised to request an itemized bill to