CMS Price Transparency Data

Vaginal delivery (full package)

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,122
Cash Discount Price: $1,306
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at The Orthopaedic Hospital of Lutheran Health Networ is $2,122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,306. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 0.96x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.

Cash / Self-Pay

$1,306

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,122

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: $1,306 (59%)

Insurance Median: $2,122 (96%)

Cash: $1,306 (59% of Medicare)

Ins. Median: $2,122 (96% 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
Physicians Health Plan	$678 - $2,054	31%
Amish Aid	$765 - $1,429	35%
Self Pay	$765 - $1,429	35%
Lutheran Preferred	$828 - $3,176	37%
Php Freedom Network	$888 - $1,659	40%
Cigna	$995 - $5,294	45%
Aetna	$1,106 - $2,568	50%
Three Rivers Preferred	$1,134 - $2,382	51%
Sagamore	$1,364 - $2,864	62%
Encore Ppo	$1,418 - $2,647	64%
Multiplan	$1,956 - $4,129	88%
Prime Health Services	$2,126 - $3,970	96%
First Health	$2,183 - $4,076	99%
One Call Work Comp	$2,197	99%
Encore	$2,268 - $4,235	102%

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 $1,306.
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 The Orthopaedic Hospital of Lutheran Health Networ 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.