CMS Price Transparency Data

Bunion correction surgery

Facility: Stoughton Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 28296
  • Insurance Median: $1,693
  • Cash Discount Price: $4,235
  • vs. Medicare Baseline: 0.51x Medicare
The contracted insurance negotiated median rate for a Bunion correction surgery at Stoughton Hospital is $1,693. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,235. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.51x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.
Cash / Self-Pay
$4,235

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,693

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: $4,235 (127%)
Insurance Median: $1,693 (51%)
Cash: $4,235 (127% of Medicare)
Ins. Median: $1,693 (51% 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.

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
Healthnet Mcr Adv - All Plans $389 12%
Tricare $389 12%
Aetna $457 - $6,006 14%
Dean Health Insurance Med Adv $457 14%
Quartz Mcr Adv $457 14%
Security Health/First Health - All Plans $457 14%
UnitedHealthcare $457 - $6,160 14%
Humana $581 - $6,930 17%
Medicaid / KanCare $606 18%
Quartz Health Solutions - All Other Lans $1,037 31%
Alliance - All Plans $1,693 51%
Blue Cross Blue Shield $1,810 54%
Dean Health Insurance Comm - All Other Plans $1,829 55%
Dean Health Insurance Epo $1,829 55%
Geha - All Plans $5,775 173%
Cigna $6,160 184%
Wisconsin Ppo Ppa Direct - All Plans $6,160 184%
Wps - All Plans $16,847 504%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 900 Ridge St, Stoughton, WI 53589
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals