CMS Price Transparency Data

Bunion correction surgery

Facility: Stoughton Hospital

Billing Code: 28296 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$1,495

about 0.4× the $3,343 Medicare rate · typically $573–$6,990

modeled estimate · not a bill or quote

What this hospital charges insurers

$581

Below the fair price — a good deal

about $914 under the fair price · 0.2× Medicare

Medicare pays $3,343 Fair price $1,495 This hospital $581 Cash price $4,235 Hospital's list price $7,700

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

A typical price — 5 charge more and 3 charge less, among the 9 WI hospitals compared.

Cheapest $526 Priciest $2,958

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Bunion correction surgery is about $1,495 (about 0.4× the $3,343 Medicare rate). Stoughton Hospital charges insurers about $581, or about $4,235 in cash — below the fair price — a good deal. Located in Stoughton, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$457 - $6,160	14%
Blue Cross Blue Shieldmajor	$1,810	54%
Aetnamajor	$457 - $6,006	14%
Cignamajor	$6,160	184%
Humanamajor	$581 - $6,930	17%
Dean Health Plan	$457 - $1,829	14%
GEHA	$5,775	173%
Health Net	$389	12%
Quartz	$457 - $1,037	14%
+ 2 smaller / regional plans	$1,693 - $16,847

Government programs also on file: Medicaid, Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,235), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 28296.

Insurance Before you use insurance

Call your insurance company to confirm Stoughton Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 28296.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Stoughton Hospital

Compare: Bunion correction surgery at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.