CMS Price Transparency Data

Bunion correction surgery

Facility: Harlem Hospital Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $3,378
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Harlem Hospital Center is $3,378. 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 1.01x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,378

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: $3,378 (101%)
Ins. Median: $3,378 (101% 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
Healthfirst $462 - $5,629 14%
Aetna $520 - $2,489 16%
Wellcare $624 19%
Fidelis $832 - $5,629 25%
Metroplus $1,200 - $5,629 36%
Amidacare $2,502 75%
Blue Cross Blue Shield $2,502 - $5,629 75%
Carelon $2,502 - $6,256 75%
Senior Whole Health $2,502 75%
United $2,502 - $4,025 75%
United Behavioral Health $2,502 - $2,752 75%
Affinity $2,552 - $5,629 76%
Carelon (Amida Care) $2,552 76%
Vnsny $2,552 - $3,840 76%
Local 1199 $2,666 80%
Emblem $3,127 - $4,821 94%
Oxford $3,326 - $3,773 99%
Elderplan $3,840 115%
Vaccn $3,840 115%
Centers Plan For Healthy Living $3,993 119%
Cigna $4,285 128%
Oscar $4,454 133%
Centerlight $4,812 144%
Magnacare $7,218 216%
Multiplan $7,700 230%
Villagecare Max $8,181 245%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 506 Lenox Avenue, New York, NY 10037
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals