CMS Price Transparency Data

Bunion correction surgery

Facility: Riverview Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $5,356
Cash Discount Price: $3,591
vs. Medicare Baseline: 1.60x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Riverview Medical Center is $5,356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,591. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.60x the Medicare baseline. Located in One Riverview Plaza, Red Bank, NJ.

Cash / Self-Pay

$3,591

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,356

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: $3,591 (107%)

Insurance Median: $5,356 (160%)

Cash: $3,591 (107% of Medicare)

Ins. Median: $5,356 (160% 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
Aetna	$981 - $8,419	29%
Karna	$1,072	32%
UnitedHealthcare	$1,189 - $14,048	36%
Clover	$1,253	37%
Seoul Medical Group	$1,510	45%
Blue Cross Blue Shield	$1,517 - $3,591	45%
Horizon	$1,534 - $10,715	46%
Cigna	$3,591 - $5,568	107%
Vaccn	$3,591	107%
Wellcare	$3,591	107%
United Community/Americhoice	$3,771	113%
Bergen Risk	$5,220	156%
Qualcare	$5,408 - $6,256	162%
Activecare First McO	$5,916	177%
Multiplan - PHCS	$5,916	177%
Amerihealth	$6,019 - $6,817	180%
Brighton Health Plan	$9,933	297%
Oxford	$11,277	337%

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 $3,591.
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 Riverview 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.