CMS Price Transparency Data

C-section delivery (full package)

Facility: St Francis Hospital - the Heart Center

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 59510
  • Insurance Median: $5,148
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a C-section delivery (full package) at St Francis Hospital - the Heart Center is $5,148. 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 $2,473.27, this hospital’s rate is 2.08x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,148

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%)
Insurance Median: $5,148 (208%)
Ins. Median: $5,148 (208% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 208% of the Medicare baseline (a markup of 108%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
UnitedHealthcare $1,779 - $4,003 72%
Brighton $3,151 - $5,879 127%
American Plan Administrators $5,148 208%
Amerihealth Administrators $5,148 208%
Benefit Services $5,148 208%
Emblem Health $5,148 208%
Ghi Cbp Ny City Employee Alternate $5,148 208%
International Benefit Administrator $5,148 208%
Ultra Benefits Inc. $5,148 208%
Zadroga $6,105 247%
Local 1199 $12,000 485%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Port Washington Boulevard, Roslyn, NY 11576
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals