CMS Price Transparency Data

Bunion correction surgery

Facility: Unitypoint Health - Meriter

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $2,511
Cash Discount Price: $4,836
vs. Medicare Baseline: 0.75x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Unitypoint Health - Meriter is $2,511. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,836. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.75x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$4,836

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,511

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: $4,836 (145%)

Insurance Median: $2,511 (75%)

Cash: $4,836 (145% of Medicare)

Ins. Median: $2,511 (75% 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
Aspirus	$482 - $4,088	14%
Blue Cross Blue Shield	$482 - $11,096	14%
Illinicare	$482 - $3,134	14%
Prevea 360	$482 - $9,928	14%
UnitedHealthcare	$482 - $6,976	14%
Humana	$506 - $3,134	15%
Meridiancare	$506 - $3,134	15%
Cigna	$975 - $3,270	29%
Health Partners Open Network	$1,012	30%
Security Health Plan	$1,044 - $3,504	31%
Mercy Care	$1,218 - $4,088	36%
Medical Associates Health Plan	$1,600	48%
Wellmark Uph Self-Funded	$1,609 - $10,922	48%

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 $4,836.
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 Unitypoint Health - Meriter 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.