Vaginal delivery (full package)
Facility: Wamego Health Center
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $1,821
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.82x 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 | 79% |
| Aetna | $1,821 | 82% |
| Medicaid / KanCare | $1,821 - $1,839 | 82% |
| Providrs Care | $2,857 | 129% |
Consumer Guidance & Cost Commentary
For the CPT code 59400, representing a vaginal delivery (full package), the negotiated rates at Wamego Health Center in Wamego, KS, range from $1,751 to $2,857 depending on the insurance carrier. The median negotiated rate across all payers is $1,821, which is significantly lower than the Medicare benchmark of $2,214.42. This facility, a Critical Access Hospital, serves four payers including UnitedHealthcare, Aetna, Medicaid/KanCare, and Providrs Care. While the data does not provide specific cash or median paid amounts, patients with high-deductible plans should be aware that paying cash upfront can sometimes result in a lower total cost than the insurance negotiated rate, provided the facility offers a prompt-pay discount. It is essential to contact the hospital directly to confirm if self-pay or prompt-pay discounts are available before scheduling, as these upfront payments can bypass the administrative costs associated with insurance claims processing.
When reviewing your final bill, ensure you receive an itemized statement rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a balance bill for the difference between the provider's chargemaster rate and your insurance allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Since the facility is located in Kansas, you should also consider how local state or county averages compare to these specific rates, though the provided data focuses on the facility's specific negotiated ranges. Always verify your deductible status