CMS Price Transparency Data

Bunion correction surgery

Facility: UPMC Williamsport

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $5,937
Cash Discount Price: $5,398
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at UPMC Williamsport is $5,937. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,398. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.78x the Medicare baseline. Located in 700 High Street, Williamsport, PA.

Cash / Self-Pay

$5,398

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,937

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: $5,398 (161%)

Insurance Median: $5,937 (178%)

Cash: $5,398 (161% of Medicare)

Ins. Median: $5,937 (178% 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	$1,389 - $6,153	42%
Upmc Work Partners	$1,792	54%
Three Rivers Provider Network	$1,917 - $8,096	57%
Multiplan	$1,979 - $7,017	59%
Aetna	$2,429 - $5,937	73%
Blue Cross Blue Shield	$3,580 - $4,216	107%
Upmc Health Plan	$3,922	117%
Coventry/First Health	$4,507 - $6,054	135%
Pa Health & Wellness	$4,948	148%
Wirerope Works	$5,002	150%
Geisinger	$6,027	180%
Cigna	$6,162	184%
America'S Choice	$7,197	215%
Intergroup	$7,197	215%

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 $5,398.
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 UPMC Williamsport 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.