CMS Price Transparency Data

Bunion correction surgery

Facility: Robert Wood Johnson University Hospital - Somerset

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $5,036
Cash Discount Price: $6,311
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Robert Wood Johnson University Hospital - Somerset is $5,036. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,311. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.51x the Medicare baseline. Located in 110 Rehill Ave, Somerville, NJ.

Cash / Self-Pay

$6,311

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,036

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: $6,311 (189%)

Insurance Median: $5,036 (151%)

Cash: $6,311 (189% of Medicare)

Ins. Median: $5,036 (151% 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	$466 - $3,546	14%
Wellpoint	$483 - $3,546	14%
Clover Health	$3,546	106%
Aetna	$3,546 - $7,036	106%
Humana	$3,546	106%
Fidelis Care	$3,546	106%
UnitedHealthcare	$3,617 - $8,043	108%
Cigna	$3,963 - $5,304	119%
Emblem Health	$6,205	186%
Wellcare	$7,056	211%
Qualcare Inc	$9,057	271%

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 $6,311.
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 Robert Wood Johnson University Hospital - Somerset 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.