CMS Price Transparency Data

Bunion correction surgery

Facility: Henry Ford Macomb Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $693
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Henry Ford Macomb Hospital is $693. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.21x the Medicare baseline. Located in 15855 Nineteen Mile Rd, Clinton Township, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$693

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%)

Insurance Median: $693 (21%)

Ins. Median: $693 (21% 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
Aetna	$281 - $3,497	8%
Blue Cross Blue Shield	$281 - $4,197	8%
Hap	$281 - $3,179	8%
Mclaren	$281	8%
Meridian Health Plan Of Mi	$281 - $4,292	8%
Priority Health	$281 - $4,523	8%
Amerihealth Michigan	$335 - $3,115	10%
Hap Caresource	$335 - $3,179	10%
Mclaren Health Plan Inc.	$335 - $862	10%
Meridian	$335 - $862	10%
Molina	$348 - $4,292	10%
Priority	$351 - $862	10%
Humana	$431 - $3,243	13%
Pace Se Mi	$498 - $819	15%
Bcn	$524 - $3,179	16%
Cca Health Mi	$524 - $862	16%
Health Alliance Plan Of Michigan	$524 - $862	16%
Mount Carmel Health Plan	$524 - $3,179	16%
United Behavioral Health, Inc.	$524 - $862	16%
UnitedHealthcare	$524 - $3,179	16%
Wellcare Ma	$524	16%
Vitalcore Physicians Group Of Mi	$682 - $7,312	20%
Cigna	$1,019	30%
Pace Of Se Mi	$3,020	90%
Cca Health Michigan	$3,179	95%
Mclaren Health	$3,179	95%
Molina Mi Health Link	$3,179	95%
Wellcare	$3,211	96%

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 $X.
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 Henry Ford Macomb 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.