CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Unitypoint Health - Meriter

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $3,300
Cash Discount Price: $5,562
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Unitypoint Health - Meriter is $3,300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,562. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.49x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$5,562

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,300

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: $5,562 (251%)

Insurance Median: $3,300 (149%)

Cash: $5,562 (251% of Medicare)

Ins. Median: $3,300 (149% 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
Aspirus	$1,599 - $2,433	72%
Cigna	$1,947	88%
Security Health Plan	$2,086	94%
Blue Cross Blue Shield	$2,102 - $10,922	95%
Illinicare	$2,102	95%
Prevea 360	$2,102 - $5,909	95%
UnitedHealthcare	$2,102 - $4,550	95%
Humana	$2,207	100%
Meridiancare	$2,207	100%
Mercy Care	$2,433	110%
Health Partners Open Network	$3,300	149%
Wellmark Uph Self-Funded	$4,624 - $10,922	209%
Medical Associates Health Plan	$6,978	315%

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 $5,562.
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 Unitypoint Health - Meriter 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.