CMS Price Transparency Data

Bunion correction surgery

Facility: Legent Orthopedic + Spine

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,221
Cash Discount Price: $5,752
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Legent Orthopedic + Spine is $3,221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,752. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.96x the Medicare baseline. Located in 5330 North Loop 1604 West, San Antonio, TX.

Cash / Self-Pay

$5,752

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,221

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: $5,752 (172%)

Insurance Median: $3,221 (96%)

Cash: $5,752 (172% of Medicare)

Ins. Median: $3,221 (96% 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
Aetna	$1,222 - $24,786	37%
UnitedHealthcare	$2,738 - $5,640	82%
Tricare	$2,958 - $24,786	88%
Medicare (plans)	$3,092 - $3,221	92%
Blue Cross Blue Shield	$3,221 - $5,749	96%
Cigna	$3,221 - $9,461	96%
Humana	$3,221	96%
Medicaid / KanCare	$3,221	96%

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 $5,752.
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 Legent Orthopedic + Spine 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.