CMS Price Transparency Data

C-section delivery (full package)

Facility: Kaleida Health

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $3,697
Cash Discount Price: $6,994
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at Kaleida Health is $3,697. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,994. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 1.49x the Medicare baseline. Located in 100 High Street, Buffalo, NY.

Cash / Self-Pay

$6,994

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,697

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: $6,994 (283%)

Insurance Median: $3,697 (149%)

Cash: $6,994 (283% of Medicare)

Ins. Median: $3,697 (149% 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
Ghi/Emblem Health	$2,957 - $3,697	120%
Ghi/Emblem Health - Wchob	$2,957 - $3,697	120%
Univera	$3,007 - $4,835	122%
Univera - Wchob	$3,007 - $4,835	122%
Aetna	$3,081	125%
Magnacare	$3,081 - $4,149	125%
Magnacare - Wchob	$3,081 - $4,149	125%

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 $6,994.
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 Kaleida Health 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.