CMS Price Transparency Data

Bunion correction surgery

Facility: Graham Regional Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $9,773
  • Cash Discount Price: $14,372
  • vs. Medicare Baseline: 2.92x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Graham Regional Medical Center is $9,773. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,372. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 2.92x the Medicare baseline. Located in 1301 Montgomery Road, Graham, TX.
Cash / Self-Pay
$14,372

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,773

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: $14,372 (430%)
Insurance Median: $9,773 (292%)
Cash: $14,372 (430% of Medicare)
Ins. Median: $9,773 (292% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 292% of the Medicare baseline (a markup of 192%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Amerigroup $4,312 129%
Choicecare Network $4,312 129%
Superior Healthplan $4,312 129%
Wellpoint $5,821 174%
Aetna $9,342 279%
Cigna $9,342 279%
Blue Cross Blue Shield $9,773 - $10,779 292%
Three Rivers Provider Network $12,216 365%
Health Advantage Network $12,935 387%
Healthsmart Preferred Care $12,935 387%
Curative $43,116 1290%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Montgomery Road, Graham, TX 76450
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals