CMS Price Transparency Data

Bunion correction surgery

Facility: Physicians Care Surgical Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $6,696
  • Cash Discount Price: $6,321
  • vs. Medicare Baseline: 2.00x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Physicians Care Surgical Hospital is $6,696. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,321. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.00x the Medicare baseline. Located in 454 Enterprise Drive, Royersford, PA.
Cash / Self-Pay
$6,321

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,696

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: $6,321 (189%)
Insurance Median: $6,696 (200%)
Cash: $6,321 (189% of Medicare)
Ins. Median: $6,696 (200% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 200% of the Medicare baseline (a markup of 100%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Keystone First $900 - $2,850 27%
Keystone First Healthplan $900 - $2,850 27%
Keystone First Vip Choice $900 - $2,850 27%
Medicaid / KanCare $900 - $2,850 27%
Pa Health And Wellness $900 - $2,850 27%
Straight Access $900 - $2,850 27%
Humana $1,318 - $12,772 39%
Tricare $1,318 - $12,772 39%
Connecticare $2,885 - $19,575 86%
Upmc $2,971 - $19,295 89%
Aarp $3,030 - $12,772 91%
Aetna $3,030 - $23,230 91%
Blue Cross Blue Shield $3,030 - $23,941 91%
Cigna $3,030 - $18,977 91%
Devon Health Services $3,030 - $12,772 91%
Gpm Health And Life Insurance Mc Supplement $3,030 - $12,772 91%
Ibc Security 65 $3,030 - $12,363 91%
Keystone 65 Hmo $3,030 - $12,772 91%
Medicare (plans) $3,030 - $12,772 91%
Pcsh Aarp $3,030 - $12,772 91%
Personal Choice 65 $3,030 - $12,363 91%
Shenandoah Life $3,030 - $12,772 91%
Unified Health Services $3,030 - $12,772 91%
UnitedHealthcare $3,030 - $27,099 91%
Vibra Health Plan $3,030 - $12,772 91%
Apwu $3,183 - $18,977 95%
Cwi Benefits $3,183 - $18,977 95%
Freedom Life Insurance Company $3,183 - $18,977 95%
Health Partners $3,183 - $18,977 95%
Healthgram $3,183 - $18,977 95%
Loomis $3,183 - $18,977 95%
Nalc Health $3,183 - $18,977 95%
Sana Benefits $3,183 - $18,977 95%
Amerihealth Administrators $3,273 - $18,753 98%
Amerihealth New Jersey Hmo $3,273 - $18,753 98%
Carefirst Administrators $3,273 - $18,753 98%
Empire Plan $3,273 - $18,753 98%
Horizon Of New Jersey $3,273 - $18,753 98%
Ibc $3,273 - $18,753 98%
Ibc - Local $3,273 - $18,753 98%
Ibc 2021 $3,273 - $18,753 98%
Ibc Local $3,273 - $18,753 98%
Independence Administrators $3,273 - $18,753 98%
Independence Bc $3,273 - $18,753 98%
Independence Federal $3,273 - $18,753 98%
Keystone Direct Pos $3,273 - $18,753 98%
Keystone Healthplan East $3,273 - $18,753 98%
Keystone Hmo $3,273 - $18,753 98%
Pcsh Ibc $3,273 - $18,753 98%
Personal Choice $3,273 - $18,753 98%
Regence Blue Shield $3,273 - $18,753 98%
Highmark $5,709 - $23,941 171%
Allsavers $6,429 - $27,099 192%
Golden Rule Op $6,429 - $27,099 192%
Oxford Health Plan $6,429 - $27,099 192%
Oxford Life Insurance Company $6,429 - $27,099 192%
Surest $6,429 - $27,099 192%
Central Pa Teamsters $6,501 - $21,231 194%
Ag Administrators $6,696 - $23,230 200%
Ag Administrators Inc $6,696 - $23,230 200%
Allied Benefit Systems $6,696 - $23,230 200%
Allied Benefits Systems $6,696 - $23,230 200%
Continental Benefits $6,696 - $23,230 200%
Coventry $6,696 - $23,230 200%
Geha $6,696 - $23,230 200%
Healthez $6,696 - $23,230 200%
Lucent Health $6,696 - $23,230 200%
Marpai Health $6,696 - $23,230 200%
Meritain Health $6,696 - $23,230 200%
Premier Care Network $6,696 - $23,230 200%
Trustmark $6,696 - $23,230 200%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 Enterprise Drive, Royersford, PA 19468
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals