CMS Price Transparency Data

Bunion correction surgery

Facility: McLaren Port Huron

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $486
Cash Discount Price: $1,951
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at McLaren Port Huron is $486. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,951. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.15x the Medicare baseline. Located in 1221 Pine Grove Ave, Port Huron, MI.

Cash / Self-Pay

$1,951

Average discount available for prompt cash payment at this facility.

Insurance Median

$486

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: $1,951 (58%)

Insurance Median: $486 (15%)

Cash: $1,951 (58% of Medicare)

Ins. Median: $486 (15% 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
Medicaid / KanCare	$335 - $348	10%
Humana	$471	14%
Medicare (plans)	$471 - $486	14%
Hap - Hmo	$502	15%
Mclaren Commercial Ins	$519	16%
U Of M Health Plan	$542	16%
Aetna	$650	19%
UnitedHealthcare	$677	20%
Priority Health	$753	23%
Blue Cross Blue Shield	$837	25%

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 $1,951.
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 McLaren Port Huron 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.