CMS Price Transparency Data

C-section delivery (full package)

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $2,789
Cash Discount Price: $1,510
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at The Orthopaedic Hospital of Lutheran Health Networ is $2,789. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,510. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 1.13x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.

Cash / Self-Pay

$1,510

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,789

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: $1,510 (61%)

Insurance Median: $2,789 (113%)

Cash: $1,510 (61% of Medicare)

Ins. Median: $2,789 (113% 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
Physicians Health Plan	$1,277 - $2,266	52%
Amish Aid	$1,442 - $1,578	58%
Self Pay	$1,442 - $1,578	58%
Lutheran Preferred	$1,560 - $3,506	63%
Php Freedom Network	$1,674 - $1,831	68%
Cigna	$1,875 - $5,843	76%
Aetna	$2,083 - $2,834	84%
Three Rivers Preferred	$2,137 - $2,629	86%
One Call Work Comp	$2,412	98%
Sagamore	$2,570 - $3,161	104%
Encore Ppo	$2,671 - $2,922	108%
Multiplan	$3,686 - $4,558	149%
Prime Health Services	$4,006 - $4,382	162%
First Health	$4,113 - $4,499	166%
Encore	$4,274 - $4,674	173%

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 $1,510.
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 The Orthopaedic Hospital of Lutheran Health Networ 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.