CMS Price Transparency Data

Bunion correction surgery

Facility: Mount Desert Island Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $1,643
Cash Discount Price: $2,365
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Mount Desert Island Hospital is $1,643. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,365. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.49x the Medicare baseline. Located in 10 Wayman Lane, Bar Harbor, ME.

Cash / Self-Pay

$2,365

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,643

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: $2,365 (71%)

Insurance Median: $1,643 (49%)

Cash: $2,365 (71% of Medicare)

Ins. Median: $1,643 (49% 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
Wellcare	$1,183	35%
Martins Point	$1,183	35%
Aetna	$1,183 - $2,405	35%
Cigna	$1,183 - $2,444	35%
Blue Cross Blue Shield	$1,183 - $2,045	35%
UnitedHealthcare	$1,183 - $1,577	35%
Healthnet	$1,708	51%
Community Health Options	$2,234	67%
Harvard Pilgrim	$2,378	71%
First Health	$2,497	75%

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 $2,365.
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 Mount Desert Island 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.