CMS Price Transparency Data

Bunion correction surgery

Facility: Brattleboro Memorial Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,187
Cash Discount Price: $737
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Brattleboro Memorial Hospital is $1,187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $737. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.36x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$737

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,187

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: $737 (22%)

Insurance Median: $1,187 (36%)

Cash: $737 (22% of Medicare)

Ins. Median: $1,187 (36% 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
Amerihealth-Caritas	$436 - $2,508	13%
New Hampshire Healthy Families	$436 - $2,508	13%
Wellsense	$436 - $3,330	13%
Blue Cross Blue Shield	$494 - $4,357	15%
Cigna	$494 - $3,206	15%
Harvard Pilgrim Health Care	$494 - $3,112	15%
Martin'S Point	$494 - $3,112	15%
Mvp Healthcare	$494 - $4,357	15%
New Hampshire Healthy Families (Wellcare)	$519 - $3,268	16%
Aetna	$605 - $1,224	18%
Coventry	$605 - $1,224	18%
Vermont Health Plan	$1,035	31%
Tufts Health Plan	$1,187	36%
Humana	$3,112	93%
UnitedHealthcare	$3,112	93%
Multiplan	$4,357	130%

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 $737.
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 Brattleboro Memorial Hospital 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.