CMS Price Transparency Data

Bunion correction surgery

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $562
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.17x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Munson Healthcare Otsego Memorial Hospital is $562. 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 0.17x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$562

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: $562 (17%)
Ins. Median: $562 (17% 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.

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 - $1,705 5%
Mclaren Health Plan $335 - $1,705 10%
Meridian $335 - $1,705 10%
Molina $335 - $1,705 10%
Priority Health $335 - $3,856 10%
UnitedHealthcare $335 - $1,705 10%
Blue Care Network $471 14%
Hap (Health Alliance Plan) $471 - $707 14%
Humana $471 14%
Medicare (plans) $471 - $3,260 14%
Michigan Amish Medical Board $471 14%
Northern Michigan Mennonite Group $471 14%
Aetna $476 14%
Asr Physicians Care Network $707 21%
Nomi Health $754 23%
Employee Benefit Logistics $801 24%
Cigna $836 - $3,856 25%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 825 N Center Ave, Gaylord, MI 49735
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals