CMS Price Transparency Data

Bunion correction surgery

Facility: Roxborough Memorial Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,506
Cash Discount Price: $3,345
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Roxborough Memorial Hospital is $3,506. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,345. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.05x the Medicare baseline. Located in 5800 Ridge Ave, Philadelphia, PA.

Cash / Self-Pay

$3,345

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,506

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: $3,345 (100%)

Insurance Median: $3,506 (105%)

Cash: $3,345 (100% of Medicare)

Ins. Median: $3,506 (105% 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
Medicaid / KanCare	$1,085	32%
Health Partners Plan	$1,582 - $5,018	47%
UnitedHealthcare	$2,040 - $6,992	61%
Humana	$2,676	80%
Blue Cross Blue Shield	$2,908 - $3,670	87%
Medicare (plans)	$3,345 - $3,512	100%
Pa Health & Wellness	$3,345 - $4,014	100%
Tricare	$3,345	100%
Providers Partner Health Plan	$3,445	103%
Keystone	$3,479 - $3,634	104%
Spartan	$3,512	105%
Auto Insurance	$3,680	110%
Worker Compensation	$3,780	113%
Employer Direct Healthcare	$4,683	140%
Naphcare	$5,185	155%
Highmark	$7,289	218%
Cigna	$7,911	237%

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 $3,345.
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 Roxborough Memorial 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.