CMS Price Transparency Data

Bunion correction surgery

Facility: Cannon Memorial Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $501
Cash Discount Price: $374
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Cannon Memorial Hospital is $501. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $374. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.15x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.

Cash / Self-Pay

$374

Average discount available for prompt cash payment at this facility.

Insurance Median

$501

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: $374 (11%)

Insurance Median: $501 (15%)

Cash: $374 (11% of Medicare)

Ins. Median: $501 (15% 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	$345 - $445	10%
Humana	$362 - $1,913	11%
Select Health Of Sc [637]	$396	12%
Absolute Total Care [58]	$453	14%
Aetna	$477 - $764	14%
Blue Choice Health Plan [922]	$477 - $1,354	14%
Blue Cross Blue Shield	$477 - $1,223	14%
Medicare (plans)	$477 - $530	14%
UnitedHealthcare	$477 - $833	14%
Vaccn - Va Community Care Network [16]	$477	14%
Veterans Administration [633]	$477	14%
Devoted Health Alt Payer [9401]	$487	15%
Devoted Health [94]	$487	15%
Cigna	$492 - $887	15%
Molina Dual Options Alt Payer [1501]	$492	15%
Molina Dual Options [15]	$492	15%
Champva [604]	$493	15%
Tricare	$493	15%
Absolute Total Care Mcr Plans Alt Payer [4101]	$494	15%
Absolute Total Care Mcr Plans [41]	$494	15%
First Choice Vip Careplus Alt Payer [3301]	$501	15%
First Choice Vip [33]	$501	15%
Nhc Advantage Alt Payer [6101]	$501	15%
Nhc Advantage [61]	$501	15%
Bright Health Alt Payer [1001]	$530	16%
Bright Health [11]	$655	20%
Ambetter / Centene	$682	20%
First Choice Next [96]	$692	21%
Molina Marketplace [97]	$692	21%
Employee Benefit Management Services [869]	$706	21%
Workers Compensation [622]	$763	23%
Mail Handlers Benefit Plan [327]	$764	23%
Rural Carrier Benefit Plan [406]	$764	23%
Geha [302]	$833	25%
Golden Rule Ins Co [584]	$833	25%
Edison Health Solutions [95]	$835	25%
Healthscope [98]	$835	25%
Preferred Administrators [19]	$882	26%
Nalc Health Benefit Plan [291]	$887	27%
Planned Administrators [886]	$965	29%
Thomas Cooper & Company [315]	$965	29%
Medcost [206]	$1,049	31%
Phcs [940]	$1,294	39%

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 $374.
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 Cannon 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.