CMS Price Transparency Data

C-section delivery (full package)

Facility: St Joseph Health System, LLC

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $3,214
Cash Discount Price: $2,170
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at St Joseph Health System, LLC is $3,214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,170. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 1.30x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.

Cash / Self-Pay

$2,170

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,214

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: $2,170 (88%)

Insurance Median: $3,214 (130%)

Cash: $2,170 (88% of Medicare)

Ins. Median: $3,214 (130% 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
Amish Aid	$1,282 - $1,402	52%
Self Pay	$1,282 - $3,214	52%
Php	$1,336 - $2,335	54%
Lutheran Preferred	$1,522 - $3,506	62%
Php Freedom Network	$1,674 - $1,831	68%
Cigna	$1,725 - $5,843	70%
Blue Cross Blue Shield	$1,938 - $2,119	78%
Veterans Eval Services	$2,342	95%
Lutheran Network	$2,404 - $3,214	97%
Three Rivers	$2,404 - $2,629	97%
Aetna	$2,457 - $3,973	99%
Encore Ppo	$2,730 - $5,259	110%
Sagamore	$2,789 - $3,161	113%
Multiplan	$3,686 - $4,558	149%
First Health	$4,006 - $4,382	162%
Prime Health Services	$4,006 - $4,382	162%
Align Network	$4,274 - $4,674	173%
Frontpath Health Coalition	$4,274 - $4,674	173%
Advantage Health Solutions	$4,434 - $4,850	179%
Allied Benefit Systems	$4,808 - $5,259	194%
Medical Mutual Of Ohio	$5,342 - $5,843	216%
Parkview Healthplan Services	$5,342 - $5,843	216%
Value Options	$5,342 - $5,843	216%

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 $2,170.
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 Joseph Health System, LLC 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.