CMS Price Transparency Data

Bunion correction surgery

Facility: Boston Medical Center-Brighton

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,921
Cash Discount Price: $4,721
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Boston Medical Center-Brighton is $3,921. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,721. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.17x the Medicare baseline. Located in 736 Cambridge Street, Nevins Building, Brighton, MA.

Cash / Self-Pay

$4,721

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,921

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: $4,721 (141%)

Insurance Median: $3,921 (117%)

Cash: $4,721 (141% of Medicare)

Ins. Median: $3,921 (117% 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
Hsn Bad Debt [4003]	$475	14%
Hsn Confidential [4007]	$475	14%
Hsn Dental [4006]	$475	14%
Hsn Partial [4002]	$475	14%
Hsn [4001]	$475	14%
Harvard Pilgrim Health Care [8001]	$2,396	72%
Blue Cross Blue Shield	$3,000 - $3,921	90%
Aetna	$3,921 - $7,674	117%
Humana	$3,921	117%
Medicare (plans)	$3,921 - $4,117	117%
Neighborhood Pace [1206]	$3,921	117%
Senior Whole Health [1210]	$3,921	117%
Ubh Hphc [8016]	$3,921	117%
United Community Plan [1202]	$3,921	117%
UnitedHealthcare	$3,921	117%
Veterans Admin [9003]	$3,921	117%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010]	$3,921	117%
Cca [1215]	$4,117	123%
Zzzcca Onecare [1216]	$4,117	123%
Eternalhealth [1227]	$4,157	124%
Fallon [8008]	$5,098	153%
Cigna	$7,200	215%
Tufts [8002]	$7,200	215%
Meritain Health [1023]	$7,674	230%
Unicare [8004]	$7,869	235%
Wellpoint [2034]	$7,869	235%
Mass General Brigham Health Plan Commercial [8009]	$7,945	238%
Mass General Brigham Health Plan Prime [7003]	$7,945	238%

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 $4,721.
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-Brighton 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.