Vaginal delivery (full package)
Facility: Memorial Hospital
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $2,079
- Cash Discount Price: $4,152
- vs. Medicare Baseline: 0.94x 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 |
|---|---|---|
| Tricare | $1,980 | 89% |
| Ambetter / Centene | $2,178 | 98% |
Consumer Guidance & Cost Commentary
For this vaginal delivery procedure at Memorial Hospital in Abilene, Kansas, the cash price is $4,152.00, which matches the facility's median negotiated rate of $2,079.00. While the facility is a Critical Access Hospital with a government ownership structure, the cash price is notably higher than the state average and exceeds the Medicare benchmark of $2,214.42. Patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance negotiated rate, as commercial contracts often include administrative overhead that inflates the allowed amount. It is important to verify the specific allowed amount with your insurer before scheduling, as in-network rates can vary significantly between providers.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. These discounts bypass the costly insurance claims process and provide immediate liquidity to the facility. Additionally, since over 80% of hospital bills contain errors, consumers should request a full itemized CPT-coded statement rather than accepting a summary bill. If you receive a balance bill from an out-of-network provider, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Always dispute any unexpected charges in writing to ensure accuracy before payment.