CMS Price Transparency Data

Bunion correction surgery

Facility: Nationwide Children's Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,947
Cash Discount Price: $2,336
vs. Medicare Baseline: 0.58x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Nationwide Children's Hospital is $1,947. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,336. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.58x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$2,336

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,947

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: $2,336 (70%)

Insurance Median: $1,947 (58%)

Cash: $2,336 (70% of Medicare)

Ins. Median: $1,947 (58% 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
Amerihealth	$513 - $6,284	15%
Bchp	$513 - $6,284	15%
Blue Cross Blue Shield	$513 - $6,284	15%
Caresource	$513 - $6,284	15%
Humana	$513 - $6,284	15%
Molina	$513 - $6,284	15%
UnitedHealthcare	$513 - $6,284	15%
Tricare	$762 - $3,082	23%
Aetna	$1,536 - $1,947	46%
Mmo	$1,869	56%
Cigna	$1,947	58%
Front Path Health Coalition	$1,947	58%
Ohc	$1,947	58%
Ohg	$1,947	58%
Ohio Ppo Connect	$1,947	58%
Osu	$1,947	58%
The Health Plan	$1,947	58%

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 $2,336.
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 Nationwide Children's Hospital 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.