Vaginal delivery (full package)
Facility: Holton Community Hospital
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $1,980
- Cash Discount Price: $2,453
- vs. Medicare Baseline: 0.89x 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 |
|---|---|---|
| UnitedHealthcare | $1,751 - $1,980 | 79% |
| Aetna | $1,751 - $2,943 | 79% |
| Medicaid / KanCare | $1,751 | 79% |
| Humana | $2,000 | 90% |
| Kansas Superior Select - All Plans | $2,019 | 91% |
Consumer Guidance & Cost Commentary
For a vaginal delivery (full package) at Holton Community Hospital in Holton, KS, the cash median price is $2,453, which is lower than the facility's negotiated rate of $2,943. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify their specific plan details, as cash-pay options can sometimes be more cost-effective than insurance negotiated rates for those with high-deductible plans. It is important to note that the facility's negotiated rate of $1,980 represents the average commercial payment, but individual payer contracts vary significantly; for instance, Medicaid/KanCare plans pay the full $1,751, while UnitedHealthcare plans average $1,751 to $1,980 depending on the specific plan.
When reviewing your bill, always request an itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you are paying out-of-pocket, ask about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid in full upfront, bypassing the administrative overhead of insurance claims processing. Additionally, compare the facility's pricing against state averages using the Medicare benchmark of $2,214.42; since commercial rates often range from 200% to 300% of Medicare, a fair pricing target is typically 120% to 150% of the Medicare amount, helping you determine if the charges are reasonable for the service provided.