Bunion correction surgery
Facility: Scott County Hospital
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $3,902
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.17x 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 | $1,049 - $6,179 | 31% |
| Wppa | $1,200 - $3,902 | 36% |
| Humana | $2,732 | 82% |
| Blue Cross Blue Shield | $3,325 | 99% |
| Aetna | $5,854 | 175% |
Consumer Guidance & Cost Commentary
For patients undergoing bunion correction surgery at Scott County Hospital in Scott City, KS, the pricing structure reveals significant variation depending on payment method and insurance status. While the facility's gross charge is $6,504, the Medicare benchmark rate is $3,342.87, which serves as a scientifically validated baseline for fair pricing. Commercial insurance plans negotiate rates that often exceed this baseline; for instance, UnitedHealthcare and WPPA have negotiated ranges starting at $1,049 and $1,200 respectively, though some plans like Aetna and Humana have fixed negotiated amounts of $5,854 and $2,732. Notably, the facility's median negotiated rate of $3,902 is higher than the Medicare benchmark, illustrating how administrative costs and contract dynamics can inflate prices above the true cost of care. Patients with high-deductible plans should consider that paying the cash price directly might be more economical than relying on insurance, as the negotiated rate could exceed the cash amount, and they should explicitly ask the hospital for self-pay or prompt-pay discounts before scheduling.
Understanding the billing mechanics is crucial for avoiding unexpected costs, particularly regarding balance billing and itemized audits. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients must remain vigilant against summary bills that obscure individual charges or verbal disputes that lack written records. Since over 80% of hospital bills contain errors, patients should request a full, itemized CPT-coded statement to identify unbundled codes or services not rendered before agreeing to any payment plan. It is also important to recognize that while the facility is a Critical Access Hospital with