CMS Price Transparency Data

Bunion correction surgery

Facility: St Mary's Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,375
Cash Discount Price: $3,261
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at St Mary's Medical Center is $3,375. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,261. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.01x the Medicare baseline. Located in 201 Nw R D Mize Rd, Blue Springs, MO.

Cash / Self-Pay

$3,261

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,375

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: $3,261 (98%)

Insurance Median: $3,375 (101%)

Cash: $3,261 (98% of Medicare)

Ins. Median: $3,375 (101% 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	$1,123 - $5,907	34%
Medicaid / KanCare	$2,766	83%
Aetna	$3,130 - $3,261	94%
Cigna	$3,261	98%
Home State	$3,261 - $5,218	98%
Medicare (plans)	$3,261 - $3,424	98%
Tricare	$3,261	98%
UnitedHealthcare	$3,261 - $5,907	98%
Veterans Evaluation Services	$3,261	98%
Kansas Superior	$3,326	99%
Healthy Blue	$3,424 - $3,955	102%
Employer Direct Healthcare	$4,566	137%
6 Degrees	$5,907	177%

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 $3,261.
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 St Mary's Medical Center 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.