CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Albany Medical Center Hospital

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,380
Cash Discount Price: $2,177
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Albany Medical Center Hospital is $2,380. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,177. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.07x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.

Cash / Self-Pay

$2,177

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,380

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: $2,177 (98%)

Insurance Median: $2,380 (107%)

Cash: $2,177 (98% of Medicare)

Ins. Median: $2,380 (107% 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.

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
Magnacare	$554	25%
Medicare (plans)	$1,669 - $2,586	75%
Medicaid / KanCare	$1,738 - $2,239	78%
Blue Shield Highmark	$1,750 - $4,197	79%
Fidelis	$1,753 - $5,354	79%
Cdphp	$1,774 - $5,354	80%
Blue Cross Blue Shield	$1,836 - $5,354	83%
Mvp	$1,879 - $3,549	85%
Tricare	$1,903 - $2,239	86%
Aetna	$2,036 - $5,102	92%
Hamaspik	$2,081 - $5,592	94%
Blue Shield	$2,082 - $5,308	94%
UnitedHealthcare	$2,226 - $4,522	101%
Nascentia	$2,448	111%
Emblem Health Ghi	$2,471 - $4,830	112%
Cigna	$2,933 - $3,549	132%
Nys Department Of Corrections	$4,506	203%
Mvp Essential Plan	$5,116	231%

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 $2,177.
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 Albany Medical Center 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.