CMS Price Transparency Data

Bunion correction surgery

Facility: Forks Community Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $2,462
Cash Discount Price: $4,079
vs. Medicare Baseline: 0.74x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Forks Community Hospital is $2,462. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,079. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.74x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$4,079

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,462

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: $4,079 (122%)

Insurance Median: $2,462 (74%)

Cash: $4,079 (122% of Medicare)

Ins. Median: $2,462 (74% 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
Medicare (plans)	$318	10%
Medicaid / KanCare	$1,635 - $2,005	49%
Coordinated Care (Mco) Mcd-All Plans	$1,766 - $2,043	53%
UnitedHealthcare	$2,104 - $4,650	63%
Community Health Network Mcr-All Other Plans	$2,127 - $2,462	64%
Humana	$2,127 - $2,462	64%
Tricare	$2,127 - $2,462	64%
Triwest-All Plans	$2,127 - $2,462	64%
Ambetter / Centene	$2,467 - $2,856	74%
Wellcare Med Adv - All Plans	$2,467 - $2,856	74%
Regence-All Other Plans	$2,722 - $3,150	81%
Community Health Exchange	$3,073 - $3,556	92%
Molina Commercial-All Other Plans	$4,349 - $5,033	130%
Blue Cross Blue Shield	$4,491 - $5,197	134%
Aetna	$4,727 - $5,471	141%
Cigna	$4,727 - $5,471	141%
First Choice-All Plans	$4,727 - $5,471	141%

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 $4,079.
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 Forks Community 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.