CMS Price Transparency Data

C-section delivery (full package)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $3,049
Cash Discount Price: $962
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at Mt Sinai Hospital Medical Center is $3,049. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $962. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 1.23x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.

Cash / Self-Pay

$962

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,049

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: $962 (39%)

Insurance Median: $3,049 (123%)

Cash: $962 (39% of Medicare)

Ins. Median: $3,049 (123% 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
Partners In Hlth - All Plans	$550	22%
Blue Cross Blue Shield	$614 - $3,932	25%
Compsych Ip/Op Only - All Plans	$825	33%
Healthlink Hmo	$893	36%
Hfn Platinum	$893	36%
Healthlink Ppo - All Other Plans	$962	39%
Multiplan Primary Ntwrk/Phcs - All Other Plans	$962	39%
Hfn Epo	$1,099	44%
Multiplan Complementary Ntwrk	$1,099	44%
Hfn Ppo - All Other Plans	$1,209	49%
Ambetter / Centene	$1,443 - $3,353	58%
Oscar - All Plans	$1,512	61%
Cigna	$1,699 - $4,129	69%
Tricare	$2,957	120%
Va Healthnet - All Plans	$2,957	120%
Advocate Physician Prtnrs Mcr	$3,049	123%
Cenpatico Illinicare Dual	$3,049	123%
Cenpatico Illinicare Mcr - All Other Plans	$3,049	123%
Humana	$3,049 - $4,315	123%
Lawndale Christian - All Plans	$3,049	123%
Meridian/Harmony D-Snp - All Plans	$3,049	123%
Nextlevel Hlth Icp Fhp Aca - All Plans	$3,049	123%
Aetna	$3,106 - $3,932	126%
Harmony Behavioral Htlh - All Plans	$3,140	127%
Zing Mcr Adv - All Plans	$3,171	128%
Molina Mcr - All Other Plans	$3,201	129%
Advocate Physician Prtnrs - All Other Plans	$3,353	136%
Family Health Network Mcaid - All Plans	$3,932	159%
Molina Mcaid	$4,129	167%

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 $962.
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 Mt Sinai Hospital Medical Center 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.