CMS Price Transparency Data

Bunion correction surgery

Facility: Southern Hills Hospital and Medical Center

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $3,107
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Southern Hills Hospital and Medical Center is $3,107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.93x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,107

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%)

Insurance Median: $3,107 (93%)

Ins. Median: $3,107 (93% 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
Sierra Hpn	$494 - $1,059	15%
Molina Healthcare	$494 - $1,101	15%
Community Care Health	$494 - $1,059	15%
Caresource	$1,101	33%
Corvel	$1,738 - $3,279	52%
Olympus Medsave USA	$1,830 - $3,452	55%
United	$2,052 - $3,180	61%
Hometown Health Providers	$2,146 - $2,619	64%
Sierra	$2,607 - $2,956	78%
Ambetter / Centene	$3,076	92%
Legacy Provider Network	$3,107	93%
Humana	$3,466	104%
Multiplan	$3,500	105%
Blue Cross Blue Shield	$3,528 - $4,589	106%
Select Health	$3,894 - $5,307	116%
Health Services Coalition	$4,260	127%
Cigna	$6,461	193%
Aetna	$14,402 - $14,460	431%

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 $X.
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 Southern Hills Hospital and Medical Center 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.