CMS Price Transparency Data

Vaginal delivery (full package)

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 59400
  • Insurance Median: $2,534
  • Cash Discount Price: $5,620
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Vaginal delivery (full package) at St Anthony Regional Hospital & Nursing Home is $2,534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,620. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.14x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.
Cash / Self-Pay
$5,620

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,534

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: $5,620 (254%)
Insurance Median: $2,534 (114%)
Cash: $5,620 (254% of Medicare)
Ins. Median: $2,534 (114% 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.

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 $1,949 - $2,270 88%
Humana $1,949 - $5,917 88%
Medica Mcr - All Plans $1,949 88%
UnitedHealthcare $1,949 - $3,001 88%
Va Ccn - All Plans $1,949 88%
Wellpoint Mcr Adv $1,949 88%
Ia Total Care Mcr $2,007 91%
Ia Total Care Comm - All Other Plans $2,534 114%
Wellmark Hmo $3,033 137%
Wellmark Ppo-All Other Plans $3,568 161%
Ia Total Care Mcaid $4,278 - $6,961 193%
Wellpoint Mcaid - All Other Plans $4,278 - $6,961 193%
Molina Mcaid - All Plans $4,364 - $7,100 197%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 311 South Clark Street, Carroll, IA 51401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals