CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Harlem Hospital Center

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,712
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Harlem Hospital Center is $2,712. 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 1.22x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,712

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: $2,712 (122%)

Ins. Median: $2,712 (122% 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
United	$1,481 - $2,999	67%
Metroplus	$2,184 - $3,570	99%
Healthfirst	$2,228 - $5,398	101%
Blue Cross Blue Shield	$2,399 - $7,449	108%
Carelon	$2,399	108%
Fidelis	$2,399 - $5,398	108%
Senior Whole Health	$2,399	108%
United Behavioral Health	$2,399 - $2,639	108%
Affinity	$2,447 - $5,398	111%
Carelon (Amida Care)	$2,447	111%
Vnsny	$2,447	111%
Aetna	$2,473 - $4,080	112%
Amidacare	$2,785	126%
Emblem	$2,785 - $3,239	126%
Wellcare	$3,008	136%
Oscar	$4,178	189%

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 Harlem Hospital Center 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.