CMS Price Transparency Data

C-section delivery (full package)

Facility: Porter Hospital Inc

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $2,464
Cash Discount Price: $5,820
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at Porter Hospital Inc is $2,464. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,820. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 1.00x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$5,820

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,464

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: $5,820 (235%)

Insurance Median: $2,464 (100%)

Cash: $5,820 (235% of Medicare)

Ins. Median: $2,464 (100% 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
Wellpath	$640 - $3,201	26%
Coventry	$757 - $3,144	31%
Blue Cross Blue Shield	$899 - $4,496	36%
Medical Corporation	$1,106 - $5,529	45%
Multiplan	$1,106 - $5,529	45%
Veterans Affairs Community Care Network	$1,164 - $2,418	47%
Mvp	$2,056 - $3,673	83%
Fidelis Care	$2,177	88%
Humana	$2,298	93%
Cigna	$2,381	96%
Aetna	$2,418	98%
Martins Point	$2,418	98%
UnitedHealthcare	$2,418 - $5,491	98%
Veterans Choice	$2,418	98%
Capital District Physicians' Health Plan	$2,464 - $4,012	100%
Harvard Pilgrim	$2,995	121%

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 $5,820.
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 Porter Hospital Inc 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.