CMS Price Transparency Data

Bunion correction surgery

Facility: St Luke's Patients Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,477
Cash Discount Price: $1,796
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at St Luke's Patients Medical Center is $3,477. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,796. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.04x the Medicare baseline. Located in 4600 East Sam Houston Parkway South, Pasadena, TX.

Cash / Self-Pay

$1,796

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,477

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: $1,796 (54%)

Insurance Median: $3,477 (104%)

Cash: $1,796 (54% of Medicare)

Ins. Median: $3,477 (104% 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
Chc	$1,034	31%
Tchp	$1,034	31%
Wellpoint	$1,088 - $4,875	33%
United	$1,110 - $6,032	33%
Aetna	$1,233 - $3,899	37%
Blue Cross Blue Shield	$2,053 - $5,256	61%
Cigna	$3,078 - $9,029	92%
Humana	$3,250 - $4,000	97%
Kelsey	$3,250	97%
Coventry	$3,334	100%
First Health	$3,334	100%
Amerivantage	$3,347	100%
Devoted	$3,477	104%
Scanhealth	$3,477	104%
Healthsmart	$3,591	107%
Multiplan	$3,848	115%
Bright Health	$4,736	142%
Ambetter / Centene	$4,875	146%
Community Health Choice	$4,875	146%
PHCS	$5,252	157%

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 $1,796.
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 St Luke's Patients 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.