CMS Price Transparency Data

Bunion correction surgery

Facility: Good Samaritan Hospital Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $3,840
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Good Samaritan Hospital Medical Center is $3,840. 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 1.15x the Medicare baseline. Located in 1000 Montauk Highway, West Islip, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,840

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: $3,840 (115%)
Ins. Median: $3,840 (115% 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
Zadroga $1,048 31%
Brighton $1,950 - $5,269 58%
Affinity Health Plan $2,510 - $5,648 75%
Centerlight Healthcare $2,510 - $3,840 75%
Elderplan Inc. $2,510 - $3,840 75%
Emblem Health $2,510 - $5,183 75%
Fidelis Care New York $2,510 - $5,648 75%
Health First $2,510 - $8,639 75%
Health Plus $2,510 - $5,648 75%
Independent Health $2,510 - $3,840 75%
Medicaid / KanCare $2,510 75%
Mvp Health Plans $2,510 - $4,753 75%
Senior Whole Health $2,510 - $3,840 75%
UnitedHealthcare $2,510 - $5,648 75%
Blue Cross Blue Shield $3,317 - $4,364 99%
Centivo $3,685 - $4,753 110%
Aetna $3,840 - $5,128 115%
Centers Plan For Healthy Living $3,840 115%
Healthspring $3,840 115%
Liberty Health $3,840 115%
Longevity Health Plan $3,840 115%
Medicare (plans) $3,840 - $4,032 115%
Orthonet - Uniformed Services Family Health Plan $3,840 115%
Pmc $3,840 115%
Tricare $3,840 115%
Universal Healthcare $3,840 115%
Us Family Health Plan $3,840 115%
Veterans Affairs $3,840 115%
Humana $3,916 117%
Local 1199 $3,945 118%
Agewell New York $3,974 119%
Partners Health Plan $4,032 121%
Wellcare Health Plan Inc $4,223 126%
Self Pay $4,364 131%
Surest $4,660 139%
Apwu $4,753 142%
Cigna $4,753 142%
Daniel H Cook $4,753 142%
Nalc $4,753 142%
Samba $4,753 142%
Mail Handlers Benefit Plan $5,128 153%
Meritain Health $5,128 153%
Nippon Life Insurance Company Of America $5,128 153%
Salvation Army $5,128 153%
American Plan Administrators $5,183 155%
Amerihealth Administrators $5,183 155%
Benefit Services $5,183 155%
Ghi Cbp Ny City Employee Alternate $5,183 155%
International Benefit Administrator $5,183 155%
Ultra Benefits Inc. $5,183 155%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Montauk Highway, West Islip, NY 11795
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals