Vaginal delivery (full package)
Facility: Nemaha Valley Community Hospital
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $3,056
- Cash Discount Price: $4,015
- vs. Medicare Baseline: 1.38x 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 |
|---|---|---|
| Celtic Comm Exch - All Plans | $329 | 15% |
| Aetna | $329 - $3,792 | 15% |
| Humana | $1,963 | 89% |
| Partners Direct Health - All Plans | $2,320 | 105% |
| Multiplan - All Plans | $4,015 | 181% |
| Midlands Choice - All Plans | $4,238 | 191% |
| Health Partners - All Plans | $4,238 | 191% |
Consumer Guidance & Cost Commentary
For the CPT code 59400, representing a vaginal delivery (full package) at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $4,015.00, which matches the lowest negotiated rate among the seven payers listed. This cash price is significantly lower than the gross charge of $4,461.00 and represents a substantial discount compared to the Medicare benchmark of $2,214.42, with commercial rates running approximately 140% above the Medicare amount. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial negotiated rates for this service range widely, from $329 to $4,238 depending on the specific insurance plan. Because the cash price of $4,015.00 is lower than the median negotiated amount of $3,056.00 reported for this facility, patients with high-deductible plans or those who have not yet met their out-of-pocket maximum may find paying cash upfront to be the most cost-effective option, potentially avoiding the administrative overhead and higher administrative markups inherent in the insurance billing cycle.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can further reduce the final bill by bypassing the costly claims processing and denial management fees that insurance companies absorb. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients must still verify their specific plan's allowed amount, as some carriers may negotiate rates as low as $