CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Boone County Hospital

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,339
Cash Discount Price: $2,789
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Boone County Hospital is $2,339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,789. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.06x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$2,789

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,339

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: $2,789 (126%)

Insurance Median: $2,339 (106%)

Cash: $2,789 (126% of Medicare)

Ins. Median: $2,339 (106% 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
Tricare	$1,394	63%
Choice Care Mcr Adv - All Plans	$1,949	88%
Humana	$1,949 - $3,137	88%
Iowa Hlth Adv - All Plans	$1,949	88%
Mt Carmel Hp - All Plans	$1,949	88%
Va Ccn-All Plans	$1,949	88%
Amerigroup Mcr Adv - All Other Plans	$1,968	89%
Aetna	$1,988 - $2,162	90%
UnitedHealthcare	$2,186 - $2,376	99%
Healthsmart Accell Network	$2,241	101%
Health Alliance-All Plans	$2,339	106%
Healthsmart Ppo - All Other Plans	$2,339	106%
Wellmark Hmo	$2,979	135%
Mutually Preferred-All Plans	$3,312	150%
Health Partners Profee Only - All Plans	$3,450	156%
Meridian Mcaid - All Plans	$3,486	157%
Wellmark Ppo - All Other Plans	$3,497	158%
Iowa Total Care Mcaid - All Plans	$3,556	161%
Medicaid / KanCare	$3,591	162%
Medical Associates Hp-All Plans	$3,703	167%
Midlands Choice-All Plans	$4,305	194%

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 $2,789.
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 Boone County Hospital 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.