CMS Price Transparency Data

Bunion correction surgery

Facility: Erlanger Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,023
Cash Discount Price: $719
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Erlanger Medical Center is $1,023. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $719. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.31x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$719

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,023

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: $719 (22%)

Insurance Median: $1,023 (31%)

Cash: $719 (22% of Medicare)

Ins. Median: $1,023 (31% 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
UnitedHealthcare	$451 - $3,125	13%
Cigna	$510 - $4,482	15%
Bluecare	$566 - $3,095	17%
Amerigroup	$597 - $1,421	18%
Caresource	$597 - $5,953	18%
Peach State Hlth Plan	$597	18%
Alexian	$668 - $2,976	20%
Blue Cross Blue Shield	$668 - $2,976	20%
Clover	$668 - $2,976	20%
Humana	$668 - $2,976	20%
Medicare (plans)	$668	20%
Upmc	$668 - $2,976	20%
Aetna	$671 - $3,066	20%
Pruitthealth Premier	$684	20%
American Health	$688 - $3,066	21%
Devoted Health	$694 - $3,095	21%
Nhc	$701 - $3,125	21%
Atrio Health	$734 - $3,274	22%
Simpra Advantage	$734	22%
Ambetter / Centene	$835 - $3,720	25%
Bluecard - Network S	$835 - $1,418	25%
Bluecard - Network P	$884 - $1,418	26%
Caresource Ga	$943 - $1,691	28%
Caresource Tn	$943 - $1,691	28%
Olympus	$1,001 - $1,135	30%
Alliant	$1,068	32%
Pnoa	$1,133 - $7,441	34%
Caresource Nc	$1,138 - $1,691	34%
Occunet	$1,168 - $2,828	35%
Point Comfort Underwriters	$1,172 - $1,202	35%
Wellpoint	$2,792	84%

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 $719.
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 Erlanger Medical Center 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.