CMS Price Transparency Data

C-section delivery (full package)

Facility: Penn State Health St. Joseph

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $10,400
Cash Discount Price: $5,375
vs. Medicare Baseline: 4.20x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at Penn State Health St. Joseph is $10,400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,375. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 4.20x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$5,375

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,400

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: $5,375 (217%)

Insurance Median: $10,400 (420%)

Cash: $5,375 (217% of Medicare)

Ins. Median: $10,400 (420% 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 420% of the Medicare baseline (a markup of 320%). 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
[Highmark Choice Blue]	$4,229	171%
[Highmark Aca]	$4,440	180%
[Highmark]	$5,286	214%
Aetna	$5,311 - $10,556	215%
[Upmc]	$7,450 - $15,269	301%
UnitedHealthcare	$8,122 - $13,992	328%
[Cbc]	$9,286 - $10,925	375%
[Ibc]	$10,272	415%
Cigna	$12,679	513%
[Geisinger]	$14,909	603%
[Preferred Healthcare Systems]	$15,500	627%
[First Health]	$16,534	669%
[Multiplan]	$16,534	669%

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 $5,375.
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 Penn State Health St. Joseph 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.