CMS Price Transparency Data

Bunion correction surgery

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,797
Cash Discount Price: $4,033
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Baylor Scott & White Medical Center - Marble Falls is $3,797. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,033. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 1.14x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$4,033

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,797

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: $4,033 (121%)

Insurance Median: $3,797 (114%)

Cash: $4,033 (121% of Medicare)

Ins. Median: $3,797 (114% 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 - $2,854	33%
Baylor Scott & White Health Plan	$2,445 - $4,709	73%
Humana	$2,854 - $5,670	85%
Triwest	$2,854	85%
Corvel	$2,990	89%
Prime Health Services	$2,990	89%
American Health Plan	$2,997	90%
Blue Cross Blue Shield	$2,997 - $4,927	90%
Healthspring	$2,997	90%
Procare Advantage	$2,997	90%
UnitedHealthcare	$3,282 - $4,376	98%
Cigna	$3,455 - $5,250	103%
Midcoast	$3,697	111%
Quiktrip	$3,697	111%
University Of Mary Hardin-Baylor	$3,898	117%
Independent Medical System	$4,033	121%
Sedgwick	$4,267	128%
Curative	$4,369	131%
First Health	$4,705	141%
Bluebell Creameries	$5,041	151%
Healthsmart	$5,041 - $7,306	151%
Private Health Care System	$5,041	151%
Three Rivers	$6,049	181%
Aetna	$8,360	250%

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 $4,033.
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 - Marble Falls 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.