CMS Price Transparency Data

Bunion correction surgery

Facility: Queens Hospital Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $2,552
Cash Discount Price: $3,743
vs. Medicare Baseline: 0.76x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Queens Hospital Center is $2,552. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,743. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.76x the Medicare baseline. Located in 82-68 164Th Street, Jamaica, NY.

Cash / Self-Pay

$3,743

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,552

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: $3,743 (112%)

Insurance Median: $2,552 (76%)

Cash: $3,743 (112% of Medicare)

Ins. Median: $2,552 (76% 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
Healthfirst	$290 - $5,629	9%
Affinity	$510 - $5,629	15%
Aetna	$520 - $2,489	16%
Blue Cross Blue Shield	$579 - $5,629	17%
Centerlight	$579 - $5,732	17%
Elderplan	$579 - $3,840	17%
Fidelis	$579 - $5,629	17%
Wellcare	$588 - $626	18%
Centers Plan For Healthy Living	$603 - $3,993	18%
Hamaspik	$608	18%
Oscar	$724 - $4,454	22%
Local 1199	$830 - $2,666	25%
Metroplus	$1,200 - $5,629	36%
Amidacare	$2,502	75%
Carelon	$2,502 - $7,452	75%
Senior Whole Health	$2,502	75%
United	$2,502 - $4,660	75%
United Behavioral Health	$2,502 - $2,752	75%
Carelon (Amida Care)	$2,552	76%
Vnsny	$2,552 - $3,840	76%
Emblem	$3,127 - $4,821	94%
Oxford	$3,326 - $3,773	99%
Vaccn	$3,840	115%
Cigna	$4,285	128%
Magnacare	$8,598	257%
Multiplan	$9,172	274%
Villagecare Max	$9,745	292%

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 $3,743.
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 Queens Hospital Center 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.