Bunion correction surgery
Facility: Wilson Medical Center
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $5,111
- Cash Discount Price: $4,792
- vs. Medicare Baseline: 1.53x 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 |
|---|---|---|
| Blue Cross Blue Shield | $3,292 - $6,389 | 98% |
| Ambetter / Centene | $3,386 - $6,389 | 101% |
| Tricare | $3,386 | 101% |
| Aetna | $3,386 - $6,389 | 101% |
| UnitedHealthcare | $3,386 - $5,942 | 101% |
| Humana | $3,386 | 101% |
| Cigna | $5,111 | 153% |
| Mulitplan-All Plans | $5,878 | 176% |
| Health Partners-All Plans | $5,878 | 176% |
Consumer Guidance & Cost Commentary
For CPT code 28296, Bunion correction surgery, Wilson Medical Center in Neodesha, KS, has a gross charge of $6,389.00. The facility's cash median rate is $4,792.00, which is lower than the median negotiated rate of $5,111.00 paid by most insurance plans. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance rates often exceed cash prices due to administrative costs and contract structures. If you have a high-deductible plan or have already met your deductible, paying the cash median of $4,792.00 upfront could result in significant savings compared to the insurance negotiated rate.
To maximize potential savings, patients should explicitly request a prompt-pay discount before scheduling, as hospitals often offer fee reductions of 20% to 50% for upfront payment. This discount bypasses the costly insurance claims processing cycle, providing immediate liquidity to the facility. Additionally, because the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, you should verify that all ancillary services are covered under your plan to avoid unexpected charges. Always ask the billing department for a full itemized bill before paying to ensure no unbundled codes or services not rendered are included in the final amount.