CMS Price Transparency Data

Bunion correction surgery

Facility: Mount Carmel St Ann's

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $5,933
  • Cash Discount Price: $26,334
  • vs. Medicare Baseline: 1.77x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Mount Carmel St Ann's is $5,933. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26,334. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.77x the Medicare baseline. Located in 500 South Cleveland Avenue, Westerville, OH.
Cash / Self-Pay
$26,334

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,933

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: $26,334 (788%)
Insurance Median: $5,933 (177%)
Cash: $26,334 (788% of Medicare)
Ins. Median: $5,933 (177% 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
Crime Victim Assistance $632 19%
Ohio Safe Program $632 19%
Medicare (plans) $2,774 - $3,313 83%
Aetna $3,092 - $5,706 92%
Blue Cross Blue Shield $3,092 - $11,769 92%
UnitedHealthcare $3,154 - $9,245 94%
Hospice Mount Carmel $3,155 94%
The Health Plan $3,218 96%
Oscar $5,206 156%
Rural Carrier Health Benefit Plan $5,706 171%
American Postal Workers Secondary $5,933 177%
Cigna $5,933 177%
Health Partners $5,933 177%
Healthgram $5,933 177%
Mvp $5,933 177%
Priority Health $5,933 177%
Enterprise Group Planning $6,089 182%
Custom Design Benefits $6,594 197%
Quality Care Partners $7,130 213%
Medical Mutual $7,753 - $11,225 232%
Geha $9,245 277%
Western & Southern Financial Group $11,225 336%
Blue Benefit Administrators Of Massachusetts $11,769 352%
Blue Care Network $11,769 352%
Blue Distinction Transplant $11,769 352%
Blue Shield - Ca $11,769 352%
Blue Shield - Id (Regence) $11,769 352%
Blue Shield - Ny Highmark Northeastern $11,769 352%
Blue Shield - Ny Highmark Western $11,769 352%
Blue Shield - Pa (Highmark) $11,769 352%
Blue Shield - Wa (Regence) $11,769 352%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 South Cleveland Avenue, Westerville, OH 43081
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals