CMS Price Transparency Data

Bunion correction surgery

Facility: Mercy Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,783
Cash Discount Price: $1,931
vs. Medicare Baseline: 0.53x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Mercy Medical Center is $1,783. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,931. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.53x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.

Cash / Self-Pay

$1,931

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,783

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: $1,931 (58%)

Insurance Median: $1,783 (53%)

Cash: $1,931 (58% of Medicare)

Ins. Median: $1,783 (53% 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
United	$314 - $3,308	9%
Summacare	$318 - $3,308	10%
Caresource	$324 - $3,407	10%
Buckeye	$330 - $3,407	10%
Amerihealth	$346 - $3,639	10%
Molina	$346 - $3,473	10%
Aetna	$490 - $2,998	15%
Blue Cross Blue Shield	$490 - $3,473	15%
Cigna	$490 - $3,088	15%
Humana	$490 - $2,998	15%
The Health Plan	$490 - $2,698	15%
Mmo	$504 - $4,898	15%
Communicare	$514 - $3,148	15%
Perennial Health	$529 - $3,238	16%
Zing Health	$539 - $3,298	16%
Aultcare	$563	17%
Oscar	$793	24%
Ohcp	$1,156	35%
Omas	$1,486	44%
Phphi	$1,783	53%
Gms	$2,080	62%
Immergrun	$2,228	67%
Multiplan	$2,674	80%

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 $1,931.
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 Mercy Medical Center 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.