CMS Price Transparency Data

Bunion correction surgery

Facility: Caromont Regional Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,477
Cash Discount Price: $5,688
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Caromont Regional Medical Center is $3,477. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,688. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.04x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.

Cash / Self-Pay

$5,688

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,477

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: $5,688 (170%)

Insurance Median: $3,477 (104%)

Cash: $5,688 (170% of Medicare)

Ins. Median: $3,477 (104% 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	$856 - $3,343	26%
Carolina Complete Health	$856	26%
Partners Behavioral Health	$856	26%
Alliance Behavioral Health	$873	26%
Amerihealth Caritas	$873	26%
Carolina Complete Health Tailored Plans	$873	26%
UnitedHealthcare	$873 - $12,515	26%
Vaya Behavioral Health	$873	26%
Wellcare	$873	26%
Absolute Total Care	$1,504	45%
Molina	$1,504 - $3,510	45%
Gaston County Jail	$1,712	51%
Aetna	$2,816 - $3,477	84%
Self Pay	$3,128	94%
Devoted Health	$3,510	105%
Healthteam	$3,510	105%
Longevity Health	$3,510	105%
Humana	$3,577 - $5,005	107%
Medcost	$3,868	116%
Cigna	$4,101 - $6,218	123%
Carolina Caring	$4,505 - $8,357	135%
Beech Street	$4,664	140%
Multiplan	$4,664	140%
First Health Network	$5,404	162%
Surgery Plus	$5,850	175%
Corporate Benefits Service	$8,992	269%

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 $5,688.
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 Caromont Regional 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.