CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,154
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Montefiore Mount Vernon Hospital is $2,154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 0.97x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,154

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%)

Insurance Median: $2,154 (97%)

Ins. Median: $2,154 (97% 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
Healthfirst	$1,788 - $3,510	81%
Amidacare	$2,154	97%
Blue Cross Blue Shield	$2,154 - $4,846	97%
Emblem	$2,154 - $18,107	97%
Fidelis	$2,154 - $3,769	97%
Medicaid / KanCare	$2,154	97%
Metroplus	$2,154 - $3,877	97%
Molina Healthcare Of Ny Affinity	$2,154 - $4,846	97%
Mvp	$2,154 - $6,666	97%
UnitedHealthcare	$2,154 - $2,452	97%
Wellcare	$2,175 - $2,197	98%
Hamaspik	$2,261 - $2,326	102%
American Postal Workers	$2,452	111%
Vnsny Choice	$2,477	112%
Vnsny Select Health	$2,477	112%
Oscar	$3,549 - $7,276	160%

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 $X.
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 Montefiore Mount Vernon 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.