CMS Price Transparency Data

Bunion correction surgery

Facility: Hospital for Special Surgery

Billing Code: 28296 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$3,290

about 1.0× the $3,343 Medicare rate · typically $1,045–$8,310

modeled estimate · not a bill or quote

What this hospital charges insurers

$12,177

Well above the fair price

about $8,887 over the fair price · 3.6× Medicare

Medicare pays $3,343 Fair price $3,290 This hospital $12,177 Cash price $15,623 Hospital's list price $16,000

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $536 Priciest $12,177

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Bunion correction surgery is about $3,290 (about 1.0× the $3,343 Medicare rate). Hospital for Special Surgery charges insurers about $12,177, or about $15,623 in cash — well above the fair price. Located in New York, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $3,290. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$548 - $14,759	16%
Blue Cross Blue Shieldmajor	$1,560 - $12,343	47%
Aetnamajor	$1,475 - $12,267	44%
Cignamajor	$1,069 - $12,245	32%
Fidelis Care	$411 - $911	12%
GEHA	$12,177	364%
Harvard Pilgrim	$14,759	442%
Molina	$8,105	242%
+ 13 smaller / regional plans	$346 - $12,343

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 15,623), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 28296.

Insurance Before you use insurance

Call your insurance company to confirm Hospital for Special Surgery is in-network.
Ask your insurer whether prior approval is required for CPT code 28296.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Hospital for Special Surgery

Compare: Bunion correction surgery at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.