Bunion correction surgery
Facility: Oakleaf Surgical Hospital
Billing Code: 28296 (CPT)
- CPT Billing Code: 28296
- Insurance Median: $3,241
- Cash Discount Price: $12,978
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $3,241 - $9,999 | 97% |
| Dean Health Plan | $3,241 | 97% |
| Group Health Cooperative Of Eau Claire | $3,241 | 97% |
| Healthpartners | $3,241 | 97% |
| Humana | $3,241 | 97% |
| Medica | $3,241 | 97% |
| Quartz Health Solutions | $3,241 | 97% |
| Security Health Plan Of Wi | $3,241 - $5,205 | 97% |
| Ucare Wi | $3,241 | 97% |
| UnitedHealthcare | $3,241 | 97% |
Consumer Guidance & Cost Commentary
Before scheduling Bunion correction surgery at Oakleaf Surgical Hospital in Altoona, Wisconsin, patients should be aware that paying cash directly can often be more affordable than using insurance. The facility's cash median rate is $12,978, which is significantly lower than the state average for this procedure. For patients with high-deductible plans, this cash price may represent the most cost-effective option, especially since the median negotiated rate paid by insurers is $3,241, a figure that exceeds the cash rate. It is crucial to explicitly request "self-pay" or "prompt-pay" discounts before check-in, as billing systems may default to insurance processing if a card is on file, potentially voiding any upfront payment incentives.
While the cash rate is competitive, the broader context of billing reveals that commercial insurance rates can sometimes be higher than expected due to administrative overhead. The gross chargemaster price listed for this service is $14,420, which serves as the baseline before any discounts or insurance negotiations apply. Patients should avoid relying on summary bills that show only broad category totals; instead, they should demand a full itemized CPT-coded statement to identify any errors, unbundled codes, or services not rendered. Furthermore, although the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, verifying the specific allowed amounts with the hospital remains essential to ensure the final charge aligns with the negotiated rates or cash options available.