CMS Price Transparency Data

Bunion correction surgery

Facility: The University of Vermont Health Network - Champl

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,023
Cash Discount Price: $2,226
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at The University of Vermont Health Network - Champl is $1,023. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,226. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.31x the Medicare baseline. Located in 75 Beekman Street, Plattsburgh, NY.

Cash / Self-Pay

$2,226

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,023

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: $2,226 (67%)

Insurance Median: $1,023 (31%)

Cash: $2,226 (67% of Medicare)

Ins. Median: $1,023 (31% 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
Mvp	$417 - $3,964	12%
Aetna	$490 - $3,964	15%
Blue Cross Blue Shield	$490 - $18,826	15%
Fidelis Care	$490 - $3,964	15%
Humana	$490 - $3,766	15%
Veterans Affairs Community Care Network	$490 - $3,964	15%
UnitedHealthcare	$571 - $3,964	17%
Wellpath	$686 - $5,946	21%
Capital District Physicians' Health Plan	$816 - $3,964	24%
Martins Point	$816 - $4,246	24%
Highmark Blueshield	$1,023 - $3,443	31%
Harvard Pilgrim	$1,781	53%
Magnacare	$1,781	53%
St. Regis	$1,781 - $3,964	53%
Coventry	$2,003	60%
Multiplan	$2,115	63%

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 $2,226.
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 The University of Vermont Health Network - Champl 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.