CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Adventist Health Lodi Memorial

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,292
Cash Discount Price: $491
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Adventist Health Lodi Memorial is $2,292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $491. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.04x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.

Cash / Self-Pay

$491

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,292

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: $491 (22%)

Insurance Median: $2,292 (104%)

Cash: $491 (22% of Medicare)

Ins. Median: $2,292 (104% 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
Alignment Health Plan (Ahp)-All Plans	$2,132	96%
Blue Shield Mcare Adv	$2,132	96%
Healthnet Mcare	$2,132	96%
Healthnet- All Other Plans	$2,132	96%
Hp Of San Joaquin Mcr Adv	$2,132	96%
Humana	$2,132	96%
Knnex Health - All Plans	$2,132	96%
Tricare	$2,132	96%
UnitedHealthcare	$2,132 - $2,803	96%
Hp Healthy Kids Pro Fee	$2,239	101%
Ah Employee Health Plan - All Plans	$2,346	106%
Cigna	$2,356	106%
Aetna	$2,489	112%
First Health- All Plans	$2,559	116%
Beech Street- All Plans	$2,772	125%
Hp Of San Joaquin Ppo - All Other Plans	$2,772	125%
Multiplan- All Plans	$2,772	125%
Kaiser Commercial - All Other Plans	$2,879	130%
Kaiser Mcr Adv	$2,879	130%
Networks By Design- All Plans	$2,879	130%
Western Growers- All Plans	$3,049	138%
Blue Shield Epn - All Other Plans	$3,218	145%
Blue Shield Non-Epn	$3,401	154%
Blue Cross Blue Shield	$3,631	164%

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 $491.
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 Lodi Memorial 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.