CMS Price Transparency Data

Bunion correction surgery

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,309
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Independence Health System Butler Memorial Hospita is $3,309. 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 0.99x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,309

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: $3,309 (99%)

Ins. Median: $3,309 (99% 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
Upmc	$471 - $4,401	14%
Ccbh - Behavioral Health	$1,510	45%
Pnoa	$1,730 - $3,434	52%
Aetna	$2,327 - $7,179	70%
Workers Comp	$2,942	88%
Highmark	$3,059 - $6,584	92%
Life Butler County	$3,121	93%
Martin'S Point - Usfhp	$3,121	93%
Medicare (plans)	$3,121	93%
Peak Health	$3,121 - $7,335	93%
Provider Partners	$3,121	93%
Tricare	$3,121	93%
UnitedHealthcare	$3,121 - $8,005	93%
Humana	$3,246	97%
Amerihealth	$3,277	98%
Geisinger	$3,277	98%
Devoted Health Plan	$3,309	99%
The Health Plan	$3,309 - $7,335	99%
Pa Health & Wellness	$3,340	100%
American Health Plan	$3,434	103%
Gateway	$3,504	105%
Highmark Aca - Direct Blue	$4,114	123%
Ellwood Group	$6,243	187%
Highmark Community Blue	$6,455	193%
Cigna	$7,132	213%
Highmark - Ind.& Managed Care	$7,316	219%

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 Independence Health System Butler Memorial Hospita 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.