CMS Price Transparency Data

Bunion correction surgery

Facility: Munson Healthcare Cadillac Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,705
Cash Discount Price: $1,958
vs. Medicare Baseline: 0.51x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Munson Healthcare Cadillac Hospital is $1,705. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,958. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.51x the Medicare baseline. Located in 400 Hobart St, Cadillac, MI.

Cash / Self-Pay

$1,958

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,705

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: $1,958 (59%)

Insurance Median: $1,705 (51%)

Cash: $1,958 (59% of Medicare)

Ins. Median: $1,705 (51% 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	$153 - $5,874	5%
Mclaren Health Plan	$335 - $3,260	10%
Meridian	$335 - $1,705	10%
Molina	$335 - $3,521	10%
Priority Health	$335 - $3,856	10%
UnitedHealthcare	$335 - $3,260	10%
American Health Associates	$471 - $3,260	14%
Autumnwood Of Mcbain Skilled Nursing	$471 - $3,260	14%
Blue Care Network	$471 - $3,260	14%
Hap (Health Alliance Plan)	$471 - $3,260	14%
Humana	$471 - $3,260	14%
Medicare (plans)	$471 - $3,260	14%
Michigan Amish Medical Board	$471 - $3,260	14%
Promedica	$471 - $3,260	14%
Samaritas Senior Living Skilled Nursing	$471 - $3,260	14%
Wellcare (Meridian)	$471 - $3,260	14%
Provider Network Of America Group Health	$660 - $1,958	20%
Asr/Physicians Care	$707 - $1,843	21%
Aetna	$742 - $3,260	22%
Cofinity	$742 - $1,797	22%
Employee Benefits Logistics	$801 - $5,542	24%
Cigna	$836 - $3,856	25%
Munson Hospice	$852 - $1,613	25%
Hospice Of Michigan	$1,382	41%
Enterprise Group Planning/Employee Benefit Plan	$1,843	55%
Medical Cost Savings Solution	$1,843	55%
Nomi Health	$1,843	55%
Robbing Group And Regency Employee Benefits	$1,843	55%
First Health/Coventry Network	$1,958	59%
Three Rivers Provider Network	$1,958	59%

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 $1,958.
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 Munson Healthcare Cadillac 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.