C-section delivery (full package)
Facility: Clay County Medical Center
Billing Code: 59510 (CPT)
- CPT Billing Code: 59510
- Insurance Median: $2,092
- Cash Discount Price: $4,368
- vs. Medicare Baseline: 0.85x 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 |
|---|---|---|
| Multiplan- All Plans | $2,092 | 85% |
| UnitedHealthcare | $2,126 | 86% |
Consumer Guidance & Cost Commentary
For a C-section delivery at Clay County Medical Center in Clay Center, KS, the cash price is $4,368.00, which matches the facility's median cash rate. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers like Multiplan and UnitedHealthcare are approximately $2,092.00, which is significantly lower than the cash price. This difference highlights a common billing dynamic where insurance contracts often result in lower out-of-pocket costs for members who have met their deductibles, whereas cash-paying patients may find the upfront cost higher than their insurer would allow.
To ensure you are not overcharged, it is important to understand that commercial rates can sometimes exceed the true cost of care, as evidenced by the facility's Medicare benchmark of $2,473.27. The cash rate of $4,368.00 represents a markup of roughly 176% over the Medicare amount, whereas fair pricing is typically defined as 120% to 150% of the Medicare rate. If your insurance plan has a high deductible or you are self-pay, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can reduce the final bill by 20% to 50%. Additionally, if you receive a summary bill, request a full itemized audit to verify that no services were unbundled or double-billed, as over 80% of hospital bills contain errors that can be corrected.