CMS Price Transparency Data

Bunion correction surgery

Facility: Fairfield Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $6,353
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Fairfield Medical Center is $6,353. 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 1.90x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,353

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: $6,353 (190%)

Ins. Median: $6,353 (190% 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
Medicaid / KanCare	$3,791	113%
Molina	$3,791 - $10,674	113%
UnitedHealthcare	$3,791 - $6,469	113%
Caresource	$3,829 - $8,410	115%
Blue Cross Blue Shield	$3,905 - $26,250	117%
Humana	$3,942 - $6,353	118%
Amerihealth Caritas Ohio	$3,980	119%
Buckeye Community Health	$3,980 - $10,028	119%
Aetna	$6,353	190%
Medical Mutual	$6,353 - $33,500	190%
Medicare (plans)	$6,353	190%
Medigold	$6,469	194%
Va Ccn	$6,469	194%
The Health Plan	$6,480	194%
Valor Health Plan	$6,480	194%
Oscar	$9,151	274%
Bwc	$14,095	422%

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 $X.
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 Fairfield 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.