CMS Price Transparency Data

Bunion correction surgery

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $2,263
Cash Discount Price: $1,883
vs. Medicare Baseline: 0.68x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Cincinnati Children's Hospital Medical Center is $2,263. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,883. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.68x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.

Cash / Self-Pay

$1,883

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,263

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: $1,883 (56%)

Insurance Median: $2,263 (68%)

Cash: $1,883 (56% of Medicare)

Ins. Median: $2,263 (68% 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
Blue Cross Blue Shield	$281 - $3,692	8%
Caresource_Oh	$281 - $330	8%
Humana	$281 - $541	8%
Amerihealth_Caritas_Oh	$289 - $339	9%
Molina_Oh	$294 - $346	9%
Buckeye_Oh	$307 - $361	9%
United_Health_Care_Oh	$334 - $393	10%
Aetna	$386 - $3,692	12%
Wellcare_Ky	$406 - $541	12%
United_Health_Care_Ky	$408 - $543	12%
Passport_Ky	$536	16%
Caresource_In	$545 - $726	16%
Caresource_Oh_Insurance	$1,846	55%
Medical_Mutual_Of_Ohio_Insurance	$1,977 - $3,360	59%
Parkview_Signature_Care_Insurance	$2,263 - $2,662	68%
United_Health_Care_Insurance	$2,271 - $3,692	68%
Point_Comfort_Insurance	$2,400	72%
Margaret_Mary_Health_Insurance	$2,448 - $2,880	73%
Cigna	$2,511 - $2,954	75%
Health_Ohio_Network_Insurance	$2,954 - $3,507	88%
Beechstreet_Insurance	$2,981 - $3,507	89%
Evolutions_Health_Care_Systems	$3,323	99%
Galaxy_Health_Insurance	$3,323	99%
Custom_Design_Benefits_Insurance	$3,507	105%
First_Health_Group_Insurance	$3,507	105%
Health_Link_Insurance	$3,507	105%
Health_Smart_Preferred_Insurance	$3,507	105%
Medical_Benefit_Administrators_Insurance	$3,507	105%
Ohio_Health_Choice_Insurance	$3,507	105%
Private_Health_Care_Systems_Insurance	$3,692	110%

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 $1,883.
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 Cincinnati Children's Hospital 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.