CMS Price Transparency Data

Bunion correction surgery

Facility: Boston Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,801
Cash Discount Price: $3,425
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Boston Medical Center is $3,801. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,425. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.14x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.

Cash / Self-Pay

$3,425

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,801

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: $3,425 (102%)

Insurance Median: $3,801 (114%)

Cash: $3,425 (102% of Medicare)

Ins. Median: $3,801 (114% 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 Conncare/Qhp [8020]	$431 - $5,400	13%
Hsn Bad Debt [4003]	$513	15%
Hsn Confidential [4007]	$513	15%
Hsn Dental [4006]	$513	15%
Hsn Partial [4002]	$513	15%
Hsn [4001]	$513	15%
UnitedHealthcare	$695 - $9,338	21%
Harvard Pilgrim Health Care [8001]	$2,361	71%
Health Plans Inc [2027]	$2,361	71%
United [2025]	$2,361 - $9,338	71%
Zzzhealth Plans Inc [1013]	$2,361	71%
Zzzunited [1008]	$2,361 - $9,338	71%
Medicaid / KanCare	$2,740	82%
Tufts [8002]	$2,746 - $5,615	82%
Blue Cross Blue Shield	$3,000	90%
Uphams Corner Esp [1213]	$3,044	91%
Workers Comp [5002]	$3,263	98%
Zzzbu Employee Work Comp [5004]	$3,263	98%
Zzzcity Of Boston Work Comp [5003]	$3,263	98%
Aetna	$3,722	111%
Meritain Health [1023]	$3,722	111%
Medicare (plans)	$3,801 - $3,991	114%
Ubh Hphc [8016]	$3,801	114%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010]	$3,801	114%
Wellcare [1240]	$3,953	118%
Cca [1215]	$3,991	119%
Corrections [9001]	$3,991 - $4,751	119%
Zzzcca Onecare [1216]	$3,991	119%
Eternalhealth [1227]	$4,029	121%
Mass General Brigham Health Plan Commercial [8009]	$4,105	123%
Fallon Sco [1126]	$4,181	125%
Senior Whole Health [1210]	$4,561	136%
Fallon [8008]	$4,941	148%
Cigna	$5,615 - $6,469	168%
Unicare [8004]	$5,708	171%
Wellpoint [2034]	$5,708	171%
Oxford Health [1007]	$9,338	279%
Oxford Health [2024]	$9,338	279%

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 $3,425.
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 Boston 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.