Bunion correction surgery
Facility: Holton Community Hospital
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $4,139
- Cash Discount Price: $3,740
- vs. Medicare Baseline: 1.24x 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 | $2,643 - $4,987 | 79% |
| UnitedHealthcare | $2,643 - $4,987 | 79% |
| Humana | $2,670 | 80% |
| Kansas Superior Select - All Plans | $2,696 | 81% |
| Blue Cross Blue Shield | $3,292 | 98% |
| Preferred Health Professionals | $4,139 | 124% |
| Preferred Health Fn Select - All Other Plans | $4,139 | 124% |
| Preferred Health Freedom | $4,139 | 124% |
| Wppa Providers - All Plans | $4,738 | 142% |
| Medicaid / KanCare | $4,987 | 149% |
Consumer Guidance & Cost Commentary
For the bunion correction surgery (CPT 28296) at Holton Community Hospital in Holton, Kansas, the negotiated rates range from $2,643 to $4,987 depending on your specific insurance plan. While the facility's cash price of $3,740 is lower than the median negotiated rate of $4,139, patients with high-deductible plans may find that paying cash upfront is more cost-effective than relying on insurance, which often processes claims at rates exceeding the cash price. It is important to note that the gross chargemaster price of $4,987 represents the maximum amount billed before discounts, and the actual amount your insurer pays varies significantly; for instance, Medicaid/KanCare plans receive a fixed rate of $4,987, while Humana and Kansas Superior Select plans pay a fixed $2,670.
When evaluating the cost against federal benchmarks, the Medicare amount for this procedure is $3,342.87, which serves as a baseline for understanding the facility's pricing structure. The facility's cash rate of $3,740 is approximately 12% higher than the Medicare amount, whereas the median negotiated rate of $4,139 is roughly 24% higher. To minimize out-of-pocket expenses, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid in full before or shortly after the service. Additionally, since over 80% of hospital bills contain errors, patients should request a detailed, itemized statement to verify