CMS Price Transparency Data

Bunion correction surgery

Facility: Surgical Institute of Reading

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $4,010
Cash Discount Price: $4,720
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Surgical Institute of Reading is $4,010. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,720. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.20x the Medicare baseline. Located in 2752 Century Boulevard, Wyomissing, PA.

Cash / Self-Pay

$4,720

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,010

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: $4,720 (141%)

Insurance Median: $4,010 (120%)

Cash: $4,720 (141% of Medicare)

Ins. Median: $4,010 (120% 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
Highmark	$682	20%
Bhp	$2,264 - $3,084	68%
Aetna	$3,084 - $5,078	92%
Geisinger Health Plan	$3,084 - $4,626	92%
Unison	$3,084	92%
Devon	$3,671	110%
Blue Cross Blue Shield	$4,010	120%
First Health	$4,160	124%
Tricare	$4,283	128%
United	$7,929	237%
Cigna	$286,322	8565%

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 $4,720.
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 Surgical Institute of Reading 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.