Bunion correction surgery
Facility: Cloud County Health Center
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $1,557
- Cash Discount Price: $1,845
- vs. Medicare Baseline: 0.47x 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 |
|---|---|---|
| Mpi-All Plans | $611 | 18% |
| Pponext-All Plans | $2,504 | 75% |
Consumer Guidance & Cost Commentary
For the bunion correction surgery (CPT 28296) at Cloud County Health Center in Concordia, KS, the facility's cash median rate of $1,845 is lower than the state average for this procedure. While the facility's negotiated rates with Mpi-All Plans and Pponext-All Plans are $611 and $2,504 respectively, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that the facility's cash rate is significantly below the Medicare benchmark of $3,342.87, suggesting a substantial markup difference between the government's cost-based reimbursement and the commercial pricing structure.
To minimize potential costs, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill. Additionally, consumers should be aware of balance billing risks, particularly if any ancillary services are provided by out-of-network providers, though the No Surprises Act offers protections for emergency and non-emergency care at in-network facilities. If an itemized bill is received, it is advisable to request a detailed, line-by-line audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.