CMS Price Transparency Data

Bunion correction surgery

Facility: Holyoke Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,650
Cash Discount Price: $2,728
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Holyoke Medical Center is $3,650. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,728. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.09x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.

Cash / Self-Pay

$2,728

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,650

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: $2,728 (82%)

Insurance Median: $3,650 (109%)

Cash: $2,728 (82% of Medicare)

Ins. Median: $3,650 (109% 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
Tufts Health Public Plans	$1,346 - $4,171	40%
Bmchp	$3,061	92%
Fallon	$3,061 - $3,824	92%
Health New England	$3,061 - $3,476	92%
Aetna	$3,476	104%
Blue Cross Blue Shield	$3,476 - $4,230	104%
Tufts Health Plan	$3,476 - $6,137	104%
UnitedHealthcare	$3,476 - $3,650	104%
Harvard Pilgrim	$3,589	107%
Commonwealth Care Alliance	$3,650	109%
Wellsense Sco	$3,685	110%
Wellcare	$3,719	111%
Wellsense Direct Metals Silver	$3,826	114%
Senior Whole Health	$3,998	120%
Cigna	$4,017	120%

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 $2,728.
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 Holyoke Medical Center 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.