CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Tri Valley Health System

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 59400
  • Insurance Median: $3,891
  • Cash Discount Price: $5,040
  • vs. Medicare Baseline: 1.76x Medicare
The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Tri Valley Health System is $3,891. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,040. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.76x the Medicare baseline. Located in 1305 West Highway 6/34, Cambridge, NE.
Cash / Self-Pay
$5,040

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,891

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: $5,040 (228%)
Insurance Median: $3,891 (176%)
Cash: $5,040 (228% of Medicare)
Ins. Median: $3,891 (176% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $329 - $5,320 15%
Humana $329 15%
Medica Mcr Adv $329 15%
Medica Prime Sol $329 15%
Tricare $329 15%
Wellcare Mcr Adv - All Plans $329 15%
Great Plains Mcr Adv - All Plans $345 16%
Healthy Blue Mcaid - All Plans $2,688 121%
Molina Mcaid - All Plans $2,688 121%
Nebraska Total Care-All Plans $2,688 121%
UnitedHealthcare $2,688 - $5,376 121%
Amerigroup Mcaid - All Plans $2,742 124%
Medica Chi Aco - All Other Plans $5,040 228%
Medica Chi Open Access $5,040 228%
Medica Ifb Aco $5,040 228%
Medica Ifb Open Access $5,040 228%
Midlands Choice-All Plans $5,040 228%
Aetna $5,488 248%
Multiplan-All Plans $5,488 248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 West Highway 6/34, Cambridge, NE 69022
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals