CMS Price Transparency Data

Bunion correction surgery

Facility: T J Samson Community Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $891
Cash Discount Price: $2,123
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at T J Samson Community Hospital is $891. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,123. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.27x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$2,123

Average discount available for prompt cash payment at this facility.

Insurance Median

$891

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3,342.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3,342.87 (100%)

Cash / Self-Pay: $2,123 (64%)

Insurance Median: $891 (27%)

Cash: $2,123 (64% of Medicare)

Ins. Median: $891 (27% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$461 - $4,547	14%
Center Care Select - All Plans	$461 - $4,547	14%
Signature Health - All Plans	$461 - $3,360	14%
Wellcare Mcr Adv - All Other Plans	$461 - $3,327	14%
Molina Mcr Adv	$470 - $3,393	14%
Devoted Mcr Adv - All Plans	$484 - $3,493	14%
Humana	$489 - $3,327	15%
Aetna	$515 - $1,183	15%
Molina Mcaid	$531 - $1,218	16%
Caresource - All Plans	$599 - $4,990	18%
Molina Marketplace - All Other Plans	$599 - $4,990	18%
Wellcare Mcaid	$1,183 - $3,260	35%
UnitedHealthcare	$4,156	124%
Phcs/Multiplan - All Plans	$5,028	150%
First Health - All Plans	$5,082	152%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,123.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 28296.

Insurance In-Network Protection Plan

Contact your insurance company to confirm T J Samson Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 28296.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.