Bunion correction surgery
Facility: Kansas City Orthopaedic Institute
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $4,365
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.31x 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 |
|---|---|---|
| Cigna | $2,500 - $3,052 | 75% |
| Aetna | $2,873 | 86% |
| UnitedHealthcare | $2,873 - $3,275 | 86% |
| Medica | $3,210 | 96% |
| Blue Cross Blue Shield | $5,455 - $11,304 | 163% |
Consumer Guidance & Cost Commentary
For the CPT code 28296, representing bunion correction surgery at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $2,500 to $11,304 depending on the insurance carrier. While the facility is physician-owned and located in an acute care hospital setting, the data does not provide specific cash or median negotiated rates for this procedure, so a direct comparison to state or county averages cannot be made. However, the Medicare benchmark for this service is $3,342.87, which serves as a critical baseline for evaluating pricing fairness. Commercial negotiated rates often exceed the Medicare rate due to administrative overhead and contract structures, yet patients should verify if their specific plan's allowed amount aligns closer to the Medicare benchmark to avoid unexpected costs.
Patients should be aware that cash-pay options may offer significant savings if the insurance negotiated rate exceeds the cash price, particularly for those with high-deductible plans. Although cash and median paid values are not listed for this code, it is standard practice to inquire about "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these can reduce the final bill by 20% to 50%. Furthermore, consumers should avoid accepting summary bills as final invoices; instead, requesting a detailed, itemized statement allows for the identification of potential errors, unbundled codes, or services not rendered, which is essential for reducing medical debt. Always confirm your deductible status and ensure you sign a waiver to prevent automatic claims submission if you choose to pay out-of-pocket.