CMS Price Transparency Data

C-section delivery (full package)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $2,561
Cash Discount Price: $7,930
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at The University of Vermont Health Network-Alice Hy is $2,561. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,930. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 1.04x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$7,930

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,561

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: $7,930 (321%)

Insurance Median: $2,561 (104%)

Cash: $7,930 (321% of Medicare)

Ins. Median: $2,561 (104% 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
Blue Cross Blue Shield	$1,948 - $3,134	79%
Fidelis Care	$2,095 - $2,834	85%
Humana	$2,095	85%
Mvp	$2,095 - $5,018	85%
Capital District Physicians' Health Plan	$2,193 - $4,012	89%
Aetna	$2,464 - $3,828	100%
UnitedHealthcare	$2,464 - $5,893	100%
Veterans Affairs Community Care Network	$2,464	100%
Martins Point	$2,486	101%
Choicecare	$2,546 - $3,310	103%
St. Regis	$4,478	181%
Magnacare	$6,344	257%
Highmark Blueshield	$7,771	314%

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 $7,930.
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 The University of Vermont Health Network-Alice Hy 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.