Bunion correction surgery
Facility: Children'S Mercy South
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $1,108
- Cash Discount Price: $988
- vs. Medicare Baseline: 0.33x 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 |
|---|---|---|
| Healthlink | $630 | 19% |
| UnitedHealthcare | $638 - $1,715 | 19% |
| Health Midwest Comprehensive Care | $680 | 20% |
| Healthy Blue | $681 - $1,259 | 20% |
| Medicaid / KanCare | $687 | 21% |
| Quiktrip | $724 | 22% |
| American Healthcare Alliance | $733 | 22% |
| Aetna | $923 - $1,176 | 28% |
| Wellfit/Centrus | $940 | 28% |
| Blue Cross Blue Shield | $962 - $1,176 | 29% |
| Humana | $965 | 29% |
| Centivo | $968 | 29% |
| Nebraska Furniture Mart | $972 | 29% |
| Orscheln | $975 | 29% |
| Multiplan | $1,027 | 31% |
| Wppa Providrs Care | $1,054 | 32% |
| Cigna | $1,115 | 33% |
| Coventry Health Care Of Kansas | $1,166 | 35% |
| Medica | $1,200 | 36% |
| Home State Health | $1,259 | 38% |
| Mercy Health | $1,502 | 45% |
| Coxhealth Network | $1,523 | 46% |
| National Preferred Provider Network | $1,811 | 54% |
Consumer Guidance & Cost Commentary
For the CPT code 28296, representing bunion correction surgery at Children's Mercy South in Overland Park, Kansas, the facility's cash median price is $988.00. This cash rate is notably lower than the facility's negotiated rates, which range from $630 to $1,811 depending on the insurance carrier. For instance, while UnitedHealthcare's negotiated rate spans from $638 to $1,715, the cash price of $988.00 could be more cost-effective for patients with high-deductible plans who have not yet met their out-of-pocket maximum. Patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
The facility's gross charge for this procedure is $2,058.00, which serves as the baseline before any insurance negotiations or discounts are applied. When compared to the Medicare benchmark of $3,342.87, the facility's cash rate is approximately 29% lower, suggesting a competitive pricing structure relative to federal cost standards. It is important to note that while the facility is a voluntary non-profit, commercial negotiated rates often exceed fair market value due to administrative overhead; for example, Blue Cross Blue Shield's negotiated range of $962 to $1,176 is higher than the cash price. Consumers are advised to avoid accepting summary bills and instead demand a detailed, itemized statement to verify that no unbundled codes or services not rendered are included in the final invoice.