Vaginal delivery (full package)
Facility: Hiawatha Community Hospital
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $3,812
- Cash Discount Price: $4,300
- vs. Medicare Baseline: 1.72x 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 |
|---|---|---|
| Aetna | $257 - $3,705 | 12% |
| Humana | $257 | 12% |
| Ambetter / Centene | $270 | 12% |
| Oscar - All Plans | $3,010 - $3,440 | 136% |
| Centrus Health Direct - All Plans | $3,010 - $3,440 | 136% |
| Blue Cross Blue Shield | $3,411 - $4,127 | 154% |
| Preferred Hlth - All Plans | $3,612 - $4,127 | 163% |
| Cigna | $3,812 - $4,357 | 172% |
| Wppa Providrs Care - All Plans | $3,812 - $4,357 | 172% |
| Multiplan - All Plans | $3,893 - $4,448 | 176% |
| Midlands Choice - All Plans | $3,893 - $4,448 | 176% |
| Healthy Blue Mcaid - All Plans | $4,013 - $4,586 | 181% |
Consumer Guidance & Cost Commentary
For the CPT code 59400, representing a vaginal delivery (full package), Hiawatha Community Hospital in Hiawatha, KS, lists a cash median price of $4,300.00, which matches the facility's gross charge. This cash rate is significantly higher than the state average, as indicated by a Medicare benchmarking ratio of 1.7, suggesting the facility's pricing is 170% of the federal baseline. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance negotiated rates for this service range from $257 to $4,586 across 12 different payers. Notably, the median negotiated rate of $3,812.00 is lower than the cash price, meaning patients with high-deductible plans or those who have met their out-of-pocket maximums might find it financially advantageous to pay the cash rate directly, provided they secure a prompt-pay discount before the claim is submitted.
To maximize savings, patients should proactively request a self-pay classification and inquire about prompt-pay discounts, which can reduce the bill by 20% to 50% when paid in full upfront. It is critical to avoid automatic claims submission, as submitting a claim to an insurance carrier can void any agreed-upon cash discount. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their itemized bills carefully to ensure no unbundled codes or services not rendered have been charged. Given that over 80% of hospital bills contain errors, requesting a detailed, line-by-line item