CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Astria Toppenish Hospital

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,543
Cash Discount Price: $2,873
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Astria Toppenish Hospital is $2,543. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,873. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.15x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.

Cash / Self-Pay

$2,873

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,543

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: $2,873 (130%)

Insurance Median: $2,543 (115%)

Cash: $2,873 (130% of Medicare)

Ins. Median: $2,543 (115% 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
Medicaid / KanCare	$676 - $2,210	31%
Li	$1,423	64%
Premera_Affordable_Care	$1,666	75%
Ambetter / Centene	$1,956	88%
UnitedHealthcare	$1,956 - $3,651	88%
Molina	$1,995	90%
Medicare (plans)	$2,015 - $3,651	91%
Va	$2,116	96%
Aetna	$2,210 - $3,890	100%
Molina_Exchange	$2,543	115%
Kaiser	$2,734	123%
Chpw_Cascade_Care	$2,785	126%
First_Choice	$3,050	138%
Tpsc	$3,448	156%
Bcchp	$4,420	200%
Great_Rivers	$4,420	200%
Healthcomp	$4,420	200%
Humana	$4,420	200%
Washington_State_Hca	$4,420	200%

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 $2,873.
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 Astria Toppenish 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.