CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Adventist Health St Helena

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,803
Cash Discount Price: $1,327
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Adventist Health St Helena is $2,803. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,327. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.27x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$1,327

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,803

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2,214.42

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,214.42 (100%)

Cash / Self-Pay: $1,327 (60%)

Insurance Median: $2,803 (127%)

Cash: $1,327 (60% of Medicare)

Ins. Median: $2,803 (127% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,214.42 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
Blue Shield Bh Mcr Adv	$2,318	105%
Blue Shield Mcr Adv	$2,318	105%
Kaiser Mcr Adv	$2,318	105%
Tricare	$2,318	105%
Ah Employee Health Plan - All Plans	$2,550	115%
Cigna	$2,561	116%
Interplan-All Plans	$2,782	126%
Kaiser-All Other Plans	$2,782	126%
UnitedHealthcare	$2,803	127%
Aetna	$2,986	135%
Blue Shield Epn-All Other Plans	$3,218	145%
Western Growers-All Plans	$3,315	150%
Blue Shield Non-Epn	$3,401	154%
Blue Cross Blue Shield	$4,235	191%
Phcs-All Plans	$4,865	220%
Health Management Network-All Plans	$7,519	340%
Three Rivers-All Plans	$7,961	360%

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 $1,327.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 59400.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 59400.
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.