CMS Price Transparency Data

C-section delivery (full package)

Facility: Aurora Medical Center

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 59510
  • Insurance Median: $16,632
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 6.72x Medicare
The contracted insurance negotiated median rate for a C-section delivery (full package) at Aurora Medical Center is $16,632. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 6.72x the Medicare baseline. Located in 975 Port Washington Road, Grafton, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,632

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%)
Insurance Median: $16,632 (672%)
Ins. Median: $16,632 (672% 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 672% of the Medicare baseline (a markup of 572%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $5,692 - $7,344 230%
Aetna $14,482 586%
Common Ground $14,619 591%
Everpointe Elite $14,688 594%
Quartz One $15,600 631%
Molina Exchange $15,818 640%
Hs Technology $17,445 705%
Health Payment Systems $17,900 724%
Centivo $18,030 729%
Quartz Group $18,250 738%
Wisconsin Physician Service $18,424 - $19,394 745%
Aurora Caregiver $19,140 774%
Trilogy $19,887 804%

Consumer Guidance & Cost Commentary

Aurora Medical Center, located at 975 Port Washington Road in Grafton, Wisconsin, is a voluntary non-profit acute care hospital with a five-star rating. For the CPT code 59510 (C-section delivery, full package), the facility's median negotiated rate is $16,632. This rate is significantly higher than the Medicare benchmark of $2,473.27, which serves as the federal cost baseline for this procedure. While the facility does not publish a specific cash or self-pay rate in the available data, patients with high-deductible plans may find that paying cash directly could result in a lower out-of-pocket cost if the insurance negotiated rate exceeds the cash price. It is important to contact the hospital directly before scheduling to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can bypass standard insurance billing cycles and administrative overhead.

The pricing landscape for this service involves 13 different payers, with negotiated rates ranging widely from a low of $5,692 at Blue Cross Blue Shield to a high of $19,887 at Trilogy. Notably, Wisconsin Physician Service offers a range between $18,424 and $19,394, while Aetna and Common Ground both list a single rate of $14,482. When reviewing your specific plan, be aware that assuming in-network status guarantees the best price is a common pitfall, as commercial rates can vary drastically between carriers. Furthermore, patients should avoid accepting summary bills that only show broad category totals; instead, request a full itemized bill to identify any errors, unbund

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 Port Washington Road, Grafton, WI 53024
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals