CMS Price Transparency Data

C-section delivery (full package)

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $2,573
Cash Discount Price: $4,955
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at St Anthony Regional Hospital & Nursing Home is $2,573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,955. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 1.04x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.

Cash / Self-Pay

$4,955

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,573

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2,473.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,473.27 (100%)

Cash / Self-Pay: $4,955 (200%)

Insurance Median: $2,573 (104%)

Cash: $4,955 (200% of Medicare)

Ins. Median: $2,573 (104% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,473.27 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
Aetna	$2,155 - $2,573	87%
Humana	$2,155 - $4,212	87%
Medica Mcr - All Plans	$2,155	87%
UnitedHealthcare	$2,155 - $3,448	87%
Va Ccn - All Plans	$2,155	87%
Wellpoint Mcr Adv	$2,155	87%
Ia Total Care Mcr	$2,219	90%
Ia Total Care Comm - All Other Plans	$2,801	113%
Wellmark Hmo	$3,369	136%
Wellmark Ppo-All Other Plans	$3,964	160%
Ia Total Care Mcaid	$4,955	200%
Wellpoint Mcaid - All Other Plans	$4,955	200%
Molina Mcaid - All Plans	$5,054	204%

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 $4,955.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 59510.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Anthony Regional Hospital & Nursing Home is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 59510.
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.