Bunion correction surgery
Facility: William Newton Hospital
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $1,448
- Cash Discount Price: $2,664
- vs. Medicare Baseline: 0.43x 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 |
|---|---|---|
| Triwest- All Plans | $430 - $1,404 | 13% |
| UnitedHealthcare | $453 - $3,619 | 14% |
| Blue Cross Blue Shield | $453 - $3,159 | 14% |
| Ambetter / Centene | $521 - $4,022 | 16% |
| Providrs Care Nexus | $2,461 | 74% |
| Providrs Care - All Other Plans | $2,815 | 84% |
Consumer Guidance & Cost Commentary
For a bunion correction surgery at William Newton Hospital in Winfield, Kansas, the cash median price is $2,664, which matches the facility's listed gross charge. This rate is significantly lower than the negotiated amounts paid by major insurers like UnitedHealthcare and Ambetter / Centene, where allowed amounts range from $453 to over $4,000 depending on the specific plan. Because commercial negotiated rates often include administrative overhead and contract markups, paying cash directly can sometimes result in substantial savings compared to what your insurance will allow. However, since this is a Critical Access Hospital with government ownership, patients should verify if their specific plan has a lower deductible or out-of-pocket maximum that might make insurance coverage more favorable than the full cash price.
To ensure you are not overcharged, it is highly recommended to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should inquire about prompt-pay discounts, which can reduce the total bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims processing cycle. While the facility's cash rate is competitive, always confirm with the hospital whether a "self-pay" or "prompt-pay" discount applies prior to scheduling, as billing systems may automatically submit claims to insurance even when a patient intends to pay out-of-network or cash, potentially voiding any agreed-upon discounts.