CMS Price Transparency Data

C-section delivery (full package)

Facility: Penobscot Valley Hospital

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $2,581
Cash Discount Price: $3,559
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at Penobscot Valley Hospital is $2,581. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,559. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 1.04x the Medicare baseline. Located in 7 Transalpine Road, Po Box 368, Lincoln, ME.

Cash / Self-Pay

$3,559

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,581

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2,473.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,473.27 (100%)

Cash / Self-Pay: $3,559 (144%)

Insurance Median: $2,581 (104%)

Cash: $3,559 (144% of Medicare)

Ins. Median: $2,581 (104% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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	$2,050 - $4,354	83%
Medicare (plans)	$2,089 - $2,542	84%
UnitedHealthcare	$2,089 - $3,315	84%
Wellcare Health Plan Inc Mcr Adv	$2,233	90%
Blue Cross Blue Shield	$2,445 - $2,717	99%
Humana	$2,542 - $2,568	103%
Harvard Pilgrim Healthcare	$3,442 - $4,331	139%
Cigna	$4,099 - $4,263	166%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,559.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 59510.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Penobscot Valley Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 59510.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.