CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Jefferson Hospital

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $3,101
Cash Discount Price: $1,286
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Jefferson Hospital is $3,101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,286. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.40x the Medicare baseline. Located in 565 Coal Valley Road, Jefferson Hills, PA.

Cash / Self-Pay

$1,286

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,101

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: $1,286 (58%)

Insurance Median: $3,101 (140%)

Cash: $1,286 (58% of Medicare)

Ins. Median: $3,101 (140% 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
University Of Pittsburgh Medical Center	$1,384 - $2,387	62%
Univera	$1,951 - $2,605	88%
Aetna	$2,143 - $2,491	97%
Highmark Wholecare	$2,465 - $2,865	111%
Pennsylvania Health And Wellness	$2,679 - $3,114	121%
Geisinger	$2,858 - $3,322	129%
UnitedHealthcare	$2,858 - $4,112	129%
Highmark	$2,931 - $3,101	132%
Amerihealth	$2,947 - $3,425	133%
Cigna	$3,862	174%
Martin'S Point	$4,966	224%

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 $1,286.
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 Jefferson Hospital 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.