CMS Price Transparency Data

Bunion correction surgery

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $2,794
Cash Discount Price: $3,688
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Univ. of Vermont - Fletcher Allen Health Care is $2,794. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,688. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.84x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$3,688

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,794

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: $3,688 (110%)

Insurance Median: $2,794 (84%)

Cash: $3,688 (110% of Medicare)

Ins. Median: $2,794 (84% 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
Mvp	$420 - $3,352	13%
Aetna	$494 - $3,270	15%
Humana	$494 - $3,270	15%
St. Regis	$494 - $3,270	15%
Veterans Affairs Community Care Network	$494 - $3,270	15%
Blue Cross Blue Shield	$504 - $7,234	15%
Fidelis Care	$568 - $3,597	17%
UnitedHealthcare	$571 - $3,960	17%
Wellpath	$692 - $4,905	21%
Capital District Physicians' Health Plan	$835 - $3,270	25%
Martins Point	$835 - $3,352	25%
Ebpa	$2,840	85%
Harvard Pilgrim	$2,950	88%
Magnacare	$2,950	88%
Coventry	$3,135	94%
Cigna	$3,226	97%
Nppn	$3,319	99%

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 $3,688.
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 Univ. of Vermont - Fletcher Allen Health Care 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.