CMS Price Transparency Data

Vaginal delivery (full package)

Facility: M Health Fairview Southdale Hospital

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $4,965
Cash Discount Price: $2,881
vs. Medicare Baseline: 2.24x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at M Health Fairview Southdale Hospital is $4,965. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,881. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 2.24x the Medicare baseline. Located in 6401 France Avenue South, Edina, MN.

Cash / Self-Pay

$2,881

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,965

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2,214.42

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,214.42 (100%)

Cash / Self-Pay: $2,881 (130%)

Insurance Median: $4,965 (224%)

Cash: $2,881 (130% of Medicare)

Ins. Median: $4,965 (224% of 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 224% of the Medicare baseline (a markup of 124%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medica	$673 - $7,727	30%
Health Partners	$1,305 - $19,148	59%
Itasca Medical Care	$1,305 - $2,114	59%
Primewest	$1,305 - $2,114	59%
South Country Health Alliance	$1,305 - $2,114	59%
Ucare	$1,330 - $5,877	60%
Hennepin Health	$1,475	67%
Blue Cross Blue Shield	$1,512 - $11,996	68%
Sanford Health Plan	$2,114 - $6,767	95%
Security Health Plan	$2,114 - $8,387	95%
UnitedHealthcare	$2,114 - $5,924	95%
Wellcare	$2,114	95%
America'S Ppo	$3,493 - $9,076	158%
First Health	$3,768 - $9,421	170%
Multiplan	$3,906 - $9,765	176%
Private Healthcare Systems	$3,906 - $9,765	176%
Wisconsin Physician Services	$4,136 - $10,340	187%

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 $2,881.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 59400.

Insurance In-Network Protection Plan

Contact your insurance company to confirm M Health Fairview Southdale Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 59400.
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.