CMS Price Transparency Data

Bunion correction surgery

Facility: Samaritan Hospital of Troy, New York

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $5,494
  • Cash Discount Price: $7,049
  • vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Samaritan Hospital of Troy, New York is $5,494. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,049. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.64x the Medicare baseline. Located in 2215 Burdett Avenue, Troy, NY.
Cash / Self-Pay
$7,049

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,494

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: $7,049 (211%)
Insurance Median: $5,494 (164%)
Cash: $7,049 (211% of Medicare)
Ins. Median: $5,494 (164% 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.

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
Capital District Physicians Health Plan $343 - $8,305 10%
Medicaid / KanCare $343 - $6,535 10%
UnitedHealthcare $2,160 - $15,063 65%
Blue Shield - Ny Highmark Northeastern $3,668 - $6,181 110%
Blue Cross Blue Shield $4,003 - $9,398 120%
Medicare (plans) $4,083 - $4,563 122%
Eddy Seniorcare Pace $4,084 122%
Secure Horizons Ma Pffs $4,163 125%
Aetna $4,323 - $5,600 129%
Hudson Headwaters Pace $4,411 132%
Nascentia Health Plus $4,575 137%
Mvp $4,834 - $6,313 145%
Allegiance $5,494 164%
American Postal Workers Secondary $5,494 164%
Cigna $5,494 164%
Diversified Administrators $5,494 164%
Health Partners $5,494 164%
Priority Health $5,494 164%
Tufts Health Plan $5,494 164%
Webtpa $5,494 164%
1199 National Benefit Fund $5,600 168%
Allied Benefit Systems $5,600 168%
Asr Health Benefits $5,600 168%
Christian Brother Services $5,600 168%
Geha $5,600 168%
Lucent Health $5,600 168%
Luminare Health $5,600 168%
Medical Mutual $5,600 168%
Meritain $5,600 168%
Trustmark Small Business Benefits $5,600 168%
Blue Shield - Ca $6,181 185%
Blue Shield - Id (Regence) $6,181 185%
Blue Shield - Ny Highmark Western $6,181 185%
Blue Shield - Pa (Highmark) $6,181 185%
Blue Shield - Wa (Regence) $6,181 185%
Fidelis Care $7,352 220%
Wellpath $9,190 275%
Bcn Domestic $9,398 281%
Blue Care Network $9,398 281%
Unicare $9,398 281%
Emblem Health $9,706 290%
Nova $9,706 290%
Harvard Pilgrim Healthcare $15,063 451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals