Bunion correction surgery
Facility: Wamego Health Center
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $395
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.12x 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 |
|---|---|---|
| UnitedHealthcare | $250 - $380 | 7% |
| Medicaid / KanCare | $260 - $399 | 8% |
| Aetna | $260 - $395 | 8% |
| Providrs Care | $1,125 | 34% |
| Tricare | $2,455 | 73% |
| Blue Cross Blue Shield | $4,367 - $4,597 | 131% |
Consumer Guidance & Cost Commentary
For the CPT code 28296, representing bunion correction surgery at Wamego Health Center in Wamego, Kansas, the facility's negotiated rates vary significantly by payer. While Medicaid/KanCare and Aetna plans have negotiated rates ranging from $260 to $395, and UnitedHealthcare ranges from $250 to $380, the facility's cash median is not available in the current data. It is important to note that cash-pay options can sometimes be more cost-effective for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, though specific cash rates were not reported here. Patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full upfront, bypassing the administrative costs associated with insurance claims processing.
When evaluating the cost of this procedure, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this service is $3,342.87, which serves as the objective baseline for fair pricing. Although the provided data does not include specific state or county average comparisons for this procedure, the facility's negotiated rates for commercial payers like Blue Cross Blue Shield ($4,367 to $4,597) and Tricare ($2,455) are notably higher than the Medicare rate. To ensure you are not overpaying, request an itemized billing audit to confirm that no unbundled codes or services not rendered are included in the final invoice, as over 80% of hospital bills