CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Northside Hospital Duluth

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 59400
  • Insurance Median: $4,907
  • Cash Discount Price: $5,489
  • vs. Medicare Baseline: 2.22x Medicare
The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Northside Hospital Duluth is $4,907. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,489. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 2.22x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$5,489

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,907

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: $5,489 (248%)
Insurance Median: $4,907 (222%)
Cash: $5,489 (248% of Medicare)
Ins. Median: $4,907 (222% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Champus Va $2,100 95%
Aetna $2,299 - $6,266 104%
Blue Cross Blue Shield $2,299 - $34,850 104%
Caresource $2,299 - $18,600 104%
Coventry $2,299 - $30,000 104%
Humana $2,299 104%
Kaiser $2,299 - $7,460 104%
Medicare (plans) $2,299 104%
UnitedHealthcare $2,299 - $8,133 104%
Va Ccn $2,299 104%
Wellcare $2,299 104%
Cigna $2,368 - $11,990 107%
Clear Springs Eon Health $2,414 109%
Clover Health $2,414 109%
Pruitt Health Premier $2,414 109%
Ambetter / Centene $2,471 - $10,726 112%
Amerigroup $2,471 - $8,978 112%
Tricare $2,471 - $6,534 112%
Georgia Reproductive Specialists $2,928 132%
Lantern $2,961 134%
Oscar $3,103 - $6,119 140%
One Call Diagnostics $3,141 142%
Us Dept Of Labor Wc $3,372 152%
Northside Health Network $3,520 - $8,102 159%
Mti $3,926 177%
Quick Trip $4,025 - $27,500 182%
Homelink $4,171 188%
Beech Steet $4,890 - $6,221 221%
Georgia Workers Compensation $4,907 222%
Novanet_Ppo $5,123 - $35,000 231%
Multiplan $6,221 281%
Multiplan Workers Comp $6,221 281%
Institutional Gwinnett County Govt $6,316 - $8,978 285%
Medicaid / KanCare $6,316 - $10,325 285%
Careiq $7,319 331%
Dekalb_Department Of Health $7,319 331%
Fifa $7,319 331%
Johnson Ferry Imaging $7,319 - $50,000 331%
Marietta Dermatology Clinical Research Inc $7,319 - $50,000 331%
Rabun County Boc $7,319 331%
West Paces Imaging Agreement $7,319 - $50,000 331%
Health One Alliance_Ppo $12,000 542%
Phcs $37,500 1693%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals