CMS Price Transparency Data

Bunion correction surgery

Facility: Artesia General Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $989
Cash Discount Price: $638
vs. Medicare Baseline: 0.30x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Artesia General Hospital is $989. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $638. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.30x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$638

Average discount available for prompt cash payment at this facility.

Insurance Median

$989

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: $638 (19%)

Insurance Median: $989 (30%)

Cash: $638 (19% of Medicare)

Ins. Median: $989 (30% 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
Zelis	$290 - $3,773	9%
First Health	$410 - $4,046	12%
Blue Cross Blue Shield	$638 - $3,190	19%
Geha	$744 - $3,144	22%
Omni Networks	$744	22%
Three Rivers Provider Network	$797	24%
Cigna	$904 - $957	27%
Galaxy Health	$957	29%
One Health Plan	$957	29%
Multiplan	$967	29%
United Payors & United Providers	$989	30%
Providence Risk & Insurance Services	$1,010 - $6,288	30%
Molina Healthcare Of New Mexico	$2,579 - $5,282	77%
Presbyterian Health Plan	$2,579 - $3,144	77%
UnitedHealthcare	$2,579 - $3,144	77%
Triwest	$3,081	92%
Humana	$3,144 - $3,458	94%
Vistacare Hospice	$3,144	94%
New Mexico Health Connections	$5,345	160%

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 $638.
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 Artesia General Hospital 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.