C-section delivery (full package)
Facility: Hiawatha Community Hospital
Billing Code: 59510 (CPT)
- CPT Billing Code: 59510
- Insurance Median: $2,873
- Cash Discount Price: $4,415
- vs. Medicare Baseline: 1.16x 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 |
|---|---|---|
| Ambetter / Centene | $2,138 | 86% |
| Humana | $2,194 | 89% |
| Aetna | $2,194 - $2,429 | 89% |
| UnitedHealthcare | $2,194 - $2,873 | 89% |
| Preferred Hlth - All Plans | $2,456 | 99% |
| Centrus Health Direct - All Plans | $2,633 | 106% |
| Wppa Providrs Care - All Plans | $3,020 | 122% |
| Multiplan - All Plans | $3,291 | 133% |
| Cigna | $3,299 | 133% |
| Oscar - All Plans | $3,510 | 142% |
| Midlands Choice - All Plans | $3,946 | 160% |
| Healthy Blue Mcaid - All Plans | $4,013 - $4,816 | 162% |
Consumer Guidance & Cost Commentary
For a C-section delivery at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $4,415.00, which matches the facility's median negotiated rate. This cash price is 120% higher than the Medicare benchmark of $2,473.27, indicating a significant markup above the federal cost baseline. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data shows no specific county or state average provided for comparison. Patients should note that commercial insurance carriers like Aetna and UnitedHealthcare have negotiated rates ranging from $2,194 to $2,873, which are lower than the cash price but may still exceed the patient's out-of-pocket costs if their deductible has not been met.
It is important to verify whether paying cash upfront could result in a lower total cost, as commercial negotiated rates often include administrative overhead that can inflate the baseline price by 20% to 40%. Before scheduling, patients should explicitly request "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount when paid in full within a short window, effectively bypassing the costly insurance claims cycle. Additionally, because the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should be cautious about signing consent waivers that might inadvertently authorize out-of-network billing for ancillary services. Always request a detailed, itemized bill before finalizing payment to ensure no errors or unbundled charges are included.