CMS Price Transparency Data

Bunion correction surgery

Facility: Montefiore New Rochelle Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,954
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Montefiore New Rochelle Hospital is $3,954. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.18x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,954

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%)

Insurance Median: $3,954 (118%)

Ins. Median: $3,954 (118% 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
UnitedHealthcare	$521 - $14,321	16%
Healthfirst	$1,308 - $3,839	39%
Oscar	$3,549 - $7,276	106%
Emblem	$3,839 - $15,963	115%
Empire	$3,839 - $9,074	115%
Fidelis	$3,839	115%
Metroplus	$3,839 - $4,991	115%
Villagecaremax	$3,839	115%
Vnsny Choice	$3,839	115%
Wellcare	$3,916	117%
Centerlight	$3,954	118%
Amidacare	$4,031	121%
Partners_Health_Plan	$4,031	121%
Hamaspik	$4,146	124%
Humana	$4,223	126%
Molina Healthcare Of Ny Affinity	$5,298	158%
Aetna	$5,500 - $6,152	165%
Northwell	$10,327	309%

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 $X.
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 Montefiore New Rochelle 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.