CMS Price Transparency Data

Bunion correction surgery

Facility: Albany Medical Center Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $859
Cash Discount Price: $787
vs. Medicare Baseline: 0.26x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Albany Medical Center Hospital is $859. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $787. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.26x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.

Cash / Self-Pay

$787

Average discount available for prompt cash payment at this facility.

Insurance Median

$859

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: $787 (24%)

Insurance Median: $859 (26%)

Cash: $787 (24% of Medicare)

Ins. Median: $859 (26% 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
Medicaid / KanCare	$288 - $801	9%
Cdphp	$333 - $5,585	10%
Medicare (plans)	$368 - $929	11%
Fidelis	$386 - $6,566	12%
Blue Cross Blue Shield	$405 - $5,585	12%
Tricare	$417 - $816	12%
Blue Shield Highmark	$443 - $1,822	13%
Hamaspik	$458 - $5,833	14%
Mvp	$464 - $3,648	14%
UnitedHealthcare	$490 - $2,041	15%
Aetna	$510 - $4,032	15%
Nascentia	$539 - $897	16%
Emblem Health Ghi	$544 - $1,770	16%
Cigna	$724 - $1,540	22%
Nys Department Of Corrections	$1,140 - $2,015	34%
Blue Shield	$2,633	79%
Mvp Essential Plan	$5,337	160%
Empire Plan Nyship	$8,696	260%

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 $787.
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 Albany Medical Center 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.