CMS Price Transparency Data

Vaginal delivery (full package)

Facility: St Joseph Health System, LLC

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,435
Cash Discount Price: $1,415
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at St Joseph Health System, LLC is $2,435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,415. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.10x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.

Cash / Self-Pay

$1,415

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,435

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: $1,415 (64%)

Insurance Median: $2,435 (110%)

Cash: $1,415 (64% of Medicare)

Ins. Median: $2,435 (110% 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
Amish Aid	$680 - $1,271	31%
Self Pay	$680 - $2,912	31%
Php	$709 - $2,115	32%
Lutheran Preferred	$808 - $3,176	36%
Php Freedom Network	$888 - $1,659	40%
Cigna	$916 - $5,294	41%
Blue Cross Blue Shield	$1,028 - $1,920	46%
Lutheran Network	$1,276 - $2,912	58%
Three Rivers	$1,276 - $2,382	58%
Aetna	$1,304 - $3,600	59%
Encore Ppo	$1,449 - $4,765	65%
Sagamore	$1,480 - $2,864	67%
Multiplan	$1,956 - $4,129	88%
Veterans Eval Services	$2,123	96%
First Health	$2,126 - $3,970	96%
Prime Health Services	$2,126 - $3,970	96%
Align Network	$2,268 - $4,235	102%
Frontpath Health Coalition	$2,268 - $4,235	102%
Advantage Health Solutions	$2,353 - $4,394	106%
Allied Benefit Systems	$2,552 - $4,765	115%
Medical Mutual Of Ohio	$2,835 - $5,294	128%
Parkview Healthplan Services	$2,835 - $5,294	128%
Value Options	$2,835 - $5,294	128%

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 $1,415.
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 St Joseph Health System, LLC 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.