Vaginal delivery (full package)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $1,986
- Cash Discount Price: $4,318
- 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 | $265 | 12% |
| Aetna | $1,986 - $3,454 | 90% |
Consumer Guidance & Cost Commentary
For the CPT code 59400, representing a vaginal delivery (full package) at Community Memorial Healthcare, Inc. in Marysville, KS, the cash median price is $4,318.00, which matches the facility's gross charge. This cash rate is significantly lower than the negotiated rates paid by in-network insurers, such as Aetna's range of $1,986 to $3,454 and UnitedHealthcare's fixed rate of $265. While the data indicates a low negotiated rate for UnitedHealthcare, patients with high-deductible plans should be aware that paying the cash price of $4,318.00 upfront can sometimes be more cost-effective than facing a large deductible or coinsurance on a higher negotiated rate. It is crucial to verify your specific plan's allowed amount and check with the hospital directly for any "self-pay" or "prompt-pay" discounts that may further reduce the out-of-pocket cost.
When evaluating the cost of this procedure, it is important to compare the facility's rates against the Medicare benchmark rather than the inflated chargemaster list. The Medicare amount for this service is $2,214.42, and the facility's cash rate represents a 90% ratio to the Medicare amount, indicating a pricing structure that is competitive relative to federal standards. Commercial negotiated rates often include administrative overheads that can inflate the baseline price, so comparing against the Medicare rate provides a clearer picture of the true cost of care. To ensure you are not overcharged, patients should request a detailed, itemized billing audit before finalizing payment, as summary bills often obscure individual charges and errors. Additionally, if