CMS Price Transparency Data

Bunion correction surgery

Facility: Baylor Scott & White Medical Center at Irving

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,552
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Baylor Scott & White Medical Center at Irving is $3,552. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.06x the Medicare baseline. Located in 1901 N Macarthur Blvd, Irving, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,552

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%)

Insurance Median: $3,552 (106%)

Ins. Median: $3,552 (106% 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
Superior Health Plan	$1,088 - $3,108	33%
Wellpoint (Fka Amerigroup)	$1,088 - $3,049	33%
Baylor Scott & White Health Plan	$2,812 - $4,884	84%
Aetna	$2,960 - $11,704	89%
Humana	$2,960	89%
Triwest	$2,960	89%
Corvel	$3,101	93%
Prime Health Services	$3,101	93%
American Health Plan	$3,108	93%
Blue Cross Blue Shield	$3,108 - $9,253	93%
Healthspring	$3,108	93%
Procare Advantage	$3,108	93%
UnitedHealthcare	$3,404 - $5,966	102%
Cigna	$5,668 - $6,668	170%
Ambetter / Centene	$6,128	183%
Healthsmart	$7,306	219%

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 $X.
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 Baylor Scott & White Medical Center at Irving 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.