CMS Price Transparency Data

Bunion correction surgery

Facility: St Mary Medical Center

Billing Code: 28296 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$3,666

about 1.1× the $3,343 Medicare rate · typically $1,519–$4,793

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,742

About the fair price

about $76 over the fair price · 1.1× Medicare

Medicare pays $3,343 Fair price $3,666 This hospital $3,742 Cash price $22,469

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $571 Priciest $3,742

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Bunion correction surgery is about $3,666 (about 1.1× the $3,343 Medicare rate). St Mary Medical Center charges insurers about $3,742, or about $22,469 in cash — about the fair price. Located in Langhorne, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,958 - $3,742	59%
Blue Cross Blue Shieldmajor	$3,220 - $9,538	96%
Aetnamajor	$1,573 - $3,733	47%
Cignamajor	$3,561 - $5,081	107%
Ambetter (Centene)	$6,296	188%
AmeriHealth	$3,220	96%
GEHA	$3,742	112%
Oscar Health	$6,349	190%
UPMC Health Plan	$5,081	152%
+ 8 smaller / regional plans	$2,581 - $7,937

Government programs also on file: Medicare, Medicaid.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 22,469), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 28296.

Insurance Before you use insurance

Call your insurance company to confirm St Mary Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 28296.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Mary Medical Center

Compare: Bunion correction surgery at other PA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.