Vaginal delivery (full package)
Facility: Providence Medical Center
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $4,130
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.87x 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 |
|---|---|---|
| Comp Alliance - Fka Compresults Worker Compensation | $4,130 | 187% |
Consumer Guidance & Cost Commentary
For the CPT code 59400, representing a vaginal delivery (full package) at Providence Medical Center in Kansas City, the facility's negotiated rate is $4,130. This amount is significantly higher than the state of Kansas average, which is reflected in the reported vs. Medicare multiplier of 1.9. While commercial insurance contracts often set a ceiling on what payers will reimburse, the administrative costs and contract structures embedded in these negotiated rates can result in final bills that exceed the actual cost of care. Patients should be aware that the "allowed amount" shown in insurance statements is not necessarily the lowest possible price and may not reflect the true cost baseline established by federal Medicare rates.
To potentially lower out-of-pocket costs, patients should inquire directly with the hospital about self-pay or prompt-pay discounts, which can range from 20% to 50% off the negotiated rate for upfront payment. Because insurance billing cycles involve complex claims processing and potential denials, paying the facility directly can sometimes bypass these administrative fees, making cash payment a more economical option for those with high-deductible plans. It is important to request a formal itemized bill before finalizing payment to ensure no unbundled charges or services not rendered are included, and to verify that any discounts applied are uniform and compliant with state regulations.