Vaginal delivery (full package)
Facility: Mcpherson Hospital
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $3,981
- Cash Discount Price: $3,851
- vs. Medicare Baseline: 1.80x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $1,742 | 79% |
| Blue Cross Blue Shield | $1,980 | 89% |
| UnitedHealthcare | $1,980 - $5,204 | 89% |
| Wellcare Mcr Adv - All Plans | $1,980 | 89% |
| Healthy Blue Mcr Adv | $1,980 | 89% |
| Va Ccn - All Plans | $1,980 | 89% |
| Humana | $1,980 | 89% |
| Ambetter / Centene | $2,277 | 103% |
| Wppa - All Plans | $3,643 | 165% |
| Medical Associates - All Plans | $3,903 | 176% |
| Central Plains - All Plans | $3,903 | 176% |
| Christian Health Aid - All Plans | $4,163 | 188% |
| Aetna | $4,293 - $5,204 | 194% |
| Multiplan - All Plans | $4,684 | 212% |
| Health Partners - All Plans | $4,944 | 223% |
| Cigna | $4,944 | 223% |
| First Health - All Plans | $4,944 | 223% |
| Medicaid / KanCare | $5,204 | 235% |
| Health Blue Mcaid - All Other Plans | $5,308 | 240% |
Consumer Guidance & Cost Commentary
For the CPT code 59400, representing a vaginal delivery (full package) at McPherson Hospital in McPherson, Kansas, the facility's cash median rate is $3,851.00, while the median amount paid by insurance is $4,228.00. This cash price is notably lower than the facility's gross charge of $5,204.00 and represents a significant discount compared to the state average, which is 1.8 times higher than the Medicare benchmark rate of $2,214.42. For patients with high-deductible plans or those without insurance, paying the cash price directly may result in lower out-of-pocket costs than relying on insurance, as the negotiated rates for many payers exceed the cash median. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
Insurance coverage varies significantly across the 19 payers listed, with negotiated rates ranging from $1,742 for Tricare up to $5,308 for Health Blue Medicaid. While some commercial payers like UnitedHealthcare and Aetna offer a range of rates depending on the specific plan, others such as Tricare and several Kansas-based insurers have a single fixed rate of $1,980.00. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services are out-of-network. To ensure accuracy and avoid errors, consumers should request a full itemized bill before paying