CMS Price Transparency Data

Bunion correction surgery

Facility: Cleveland Clinic

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,916
Cash Discount Price: $1,931
vs. Medicare Baseline: 0.57x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Cleveland Clinic is $1,916. 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 0.57x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.

Cash / Self-Pay

$1,931

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,916

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: $1,916 (57%)

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

Ins. Median: $1,916 (57% 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
UnitedHealthcare	$299 - $4,057	9%
Summacare	$318 - $3,008	10%
Paramount	$324 - $4,398	10%
Buckeye	$330 - $4,484	10%
Caresource	$330 - $4,270	10%
United	$336 - $7,778	10%
Amerihealth	$346	10%
Molina	$346 - $4,484	10%
Aetna	$490 - $3,008	15%
Blue Cross Blue Shield	$490 - $4,484	15%
Devoted Health	$490 - $3,008	15%
Humana	$490 - $3,008	15%
The Health Plan	$490 - $3,008	15%
Upmc	$490 - $3,008	15%
Valor	$490 - $3,008	15%
Cigna	$504 - $3,098	15%
Communicare	$514 - $3,158	15%
Perennial Health	$529 - $3,249	16%
Pphp	$529 - $3,309	16%
Zing Health	$539 - $3,309	16%
Oscar	$793	24%
Cc Ehp	$931	28%
Ohcp	$1,156	35%
Ohio Healthy	$1,188	36%
Aultcare	$1,278	38%
Amish Community Aid Plan	$1,337	40%
Omas	$1,486	44%
Healthsmart	$1,634	49%
Mmo	$1,671 - $8,227	50%
Phphi	$1,783	53%
Clarity Health	$1,931	58%
Gms	$2,080	62%
Quality Care Partners	$2,080	62%
Consociate Health	$2,228	67%
Multiplan	$2,674	80%
Three Rivers	$2,674	80%
Usa Managed Care	$2,674	80%
United Bh	$4,697	141%

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 Cleveland Clinic 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.