Bunion correction surgery
Facility: Memorial Hospital
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $475
- Cash Discount Price: $2,636
- vs. Medicare Baseline: 0.14x 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 |
|---|---|---|
| Tricare | $453 | 14% |
| Ambetter / Centene | $498 | 15% |
Consumer Guidance & Cost Commentary
For the CPT code 28296, representing bunion correction surgery at Memorial Hospital in Abilene, KS, the cash price is $2,636.00, which matches the facility's cash median. This rate is significantly lower than the Medicare benchmark of $3,342.87, indicating a markup of only 10% above the federal baseline. While the hospital is a Critical Access Hospital owned by a Government Hospital District, patients should note that commercial insurance negotiated rates for this service are approximately $475.00, which is substantially lower than both the cash price and the Medicare amount. However, because these negotiated rates are often subject to deductibles and co-pays, the actual out-of-pocket cost for a patient with a high deductible may exceed the cash price, making the $2,636.00 cash rate a potentially more affordable option for those without active insurance coverage.
To minimize costs, patients should verify their specific insurance status and ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to avoid assuming that being in-network guarantees the lowest price, as some in-network facilities charge significantly more than others for the same procedure. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected. Given that the facility is located in Abilene, KS, and operates as a Critical Access Hospital, comparing this specific