CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Fairfield Medical Center

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $4,485
Cash Discount Price: $2,904
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Fairfield Medical Center is $4,485. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,904. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 2.03x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$2,904

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,485

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: $2,904 (131%)

Insurance Median: $4,485 (203%)

Cash: $2,904 (131% of Medicare)

Ins. Median: $4,485 (203% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Oscar	$2,259	102%
Medical Mutual	$2,904 - $4,324	131%
Molina	$3,226	146%
Blue Cross Blue Shield	$3,343 - $3,594	151%
Humana	$3,872 - $6,130	175%
Aetna	$4,233	191%
The Health Plan	$4,465	202%
Allied Benefit Systems	$4,485	203%
Meritain Health	$4,485	203%
Quality Care Partners/Ohio Ppo Connect	$4,646	210%
The Ohio State Health Plan	$4,969	224%
Cigna	$5,066 - $5,317	229%
UnitedHealthcare	$5,267	238%
Ohio Healthy	$6,066	274%
Multiplan	$6,130	277%
Miscellaneous Plans	$6,453	291%

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 $2,904.
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 Fairfield Medical 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.