CMS Price Transparency Data

Bunion correction surgery

Facility: Methodist Hospital Stone Oak

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,616
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Methodist Hospital Stone Oak is $3,616. 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 1.08x the Medicare baseline. Located in 1139 E Sonterra Blvd,, San Antonio, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,616

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: $3,616 (108%)

Ins. Median: $3,616 (108% 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
Community First Health Plans	$365 - $1,110	11%
United	$1,088 - $9,990	33%
Usa Managed Care Chip	$1,088	33%
Molina Healthcare	$1,197	36%
Amerigroup	$1,202	36%
Humana	$1,360	41%
Aetna	$1,374 - $3,379	41%
First Health	$2,099	63%
Fidelis Securecare	$2,115	63%
Superior Health	$2,369	71%
Wellcare	$3,386 - $3,451	101%
Imperial Insurance	$3,616	108%
Blue Cross Blue Shield	$4,216 - $7,063	126%
Oscar	$5,240	157%
Focus Health Solutions	$5,261	157%
Valenz	$5,471	164%
Cigna	$5,701 - $7,548	171%
Healthcare Highways	$5,718	171%
Curative Administrators	$5,849	175%
Evry Health	$6,713	201%

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 Methodist Hospital Stone Oak 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.