C-section delivery (full package)
Facility: Holton Community Hospital
Billing Code: 59510 (CPT)
- CPT Billing Code: 59510
- Insurance Median: $2,991
- Cash Discount Price: $2,703
- vs. Medicare Baseline: 1.21x 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 $2,473.27 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $1,910 - $2,523 | 77% |
| Aetna | $1,910 - $3,604 | 77% |
| Humana | $1,929 | 78% |
| Kansas Superior Select - All Plans | $1,948 | 79% |
| Preferred Health Professionals | $2,991 | 121% |
| Preferred Health Freedom | $2,991 | 121% |
| Preferred Health Fn Select - All Other Plans | $2,991 | 121% |
| Wppa Providers - All Plans | $3,424 | 138% |
| Medicaid / KanCare | $3,604 | 146% |
Consumer Guidance & Cost Commentary
For a C-section delivery at Holton Community Hospital in Holton, Kansas, the cash price of $2,703 is lower than the facility's gross charge of $3,604, offering a potential savings for patients with high-deductible plans who may not have met their insurance thresholds. While the hospital's negotiated rate with most payers averages $2,991, which is slightly higher than the cash price, the facility's rates remain within the range of commercial payer contracts, with the lowest negotiated amounts starting at $1,910 for UnitedHealthcare and Aetna. It is important to note that commercial negotiated rates often include administrative overhead and can exceed cash prices; therefore, patients should verify their specific plan's deductible status before assuming insurance will result in a lower out-of-pocket cost than paying cash directly.
When evaluating the cost against federal benchmarks, the Medicare amount for this procedure is $2,473.27, serving as a scientifically validated baseline for the true cost of care. The facility's cash price of $2,703 represents a markup of approximately 9% over the Medicare rate, which aligns with fair pricing standards typically defined as 120% to 150% of the Medicare amount, whereas commercial negotiated rates often average 200% to 300% of this baseline. To maximize savings, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid upfront, and request a detailed itemized bill to ensure no errors or unbundled charges are included before finalizing payment.