CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,287
Cash Discount Price: $5,282
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Nationwide Children's Hospital Toledo, LLC is $2,287. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,282. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.03x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$5,282

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,287

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: $5,282 (239%)

Insurance Median: $2,287 (103%)

Cash: $5,282 (239% of Medicare)

Ins. Median: $2,287 (103% 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
Molina	$1,749	79%
UnitedHealthcare	$1,749 - $3,521	79%
Amerihealth	$1,766	80%
Bchp	$1,766	80%
Blue Cross Blue Shield	$1,766 - $3,311	80%
Humana	$1,766	80%
Caresource	$2,163	98%
Paramount	$2,163	98%
Mcclaren Health Plan - Michigan	$2,287	103%
Tricare	$2,478	112%
Front Path Health Coalition	$2,812	127%
Aetna	$2,842	128%
Mcclaren Health Plan	$3,028	137%
Ohc	$6,602	298%
Ohio Ppo Connect	$6,602	298%
Cigna	$6,838	309%

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 $5,282.
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 Nationwide Children's Hospital Toledo, LLC 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.