Vaginal delivery (full package)
Facility: Great Plains Of Sabetha
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $1,990
- Cash Discount Price: $3,911
- vs. Medicare Baseline: 0.90x 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 - $1,881 | 79% |
| Medicaid / KanCare | $1,751 | 79% |
| Aetna | $1,769 - $2,216 | 80% |
| Celtic Mcr Adv | $1,980 | 89% |
| Celtic Comm Exchange-All Other Plans | $2,475 | 112% |
| Great West Healthcare-All Plans | $3,324 | 150% |
| Century/Wppa/Providers-All Plans | $3,520 | 159% |
| Multiplan-Phcs-All Plans | $3,715 | 168% |
| Federated Mutual Ins-All Plans | $3,755 | 170% |
Consumer Guidance & Cost Commentary
For the vaginal delivery procedure at Great Plains of Sabetha, the cash median price is $3,911.00, which matches the facility's gross charge. This rate is significantly higher than the state of Kansas average, where the median negotiated rate is $1,990.00. While commercial insurance plans like UnitedHealthcare and Medicaid/KanCare have negotiated rates ranging from $1,751 to $1,881, these amounts are still lower than the cash price. Patients with high-deductible plans or those who have already met their out-of-pocket maximums may find paying the cash price directly more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. It is important to note that while the facility is a Critical Access Hospital in Sabetha, KS, and operates as a voluntary non-profit, patients should always verify their specific plan's deductible status before scheduling to avoid unexpected financial gaps.
The facility's billing structure reflects standard industry practices where negotiated rates are often inflated by administrative costs and contract dynamics, resulting in prices that can exceed the true cost of care represented by Medicare benchmarks. For this service, the Medicare amount is $2,214.42, which serves as a scientifically validated baseline for fair pricing. Although the facility offers a cash median of $3,911.00, patients should proactively inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, if a patient receives care from out-of-network providers within the facility, they may face balance billing for services not covered by