CMS Price Transparency Data

C-section delivery (full package)

Facility: Tomah Memorial Hospital

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $2,145
Cash Discount Price: $3,852
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at Tomah Memorial Hospital is $2,145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,852. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 0.87x the Medicare baseline. Located in 501 Gopher Dr, Tomah, WI.

Cash / Self-Pay

$3,852

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,145

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: $3,852 (156%)

Insurance Median: $2,145 (87%)

Cash: $3,852 (156% of Medicare)

Ins. Median: $2,145 (87% 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
Security Hp Mcaid	$1,034	42%
Blue Cross Blue Shield	$1,356 - $3,959	55%
Independent Care Mcaid	$1,356	55%
Managed Hlth Mcaid - All Plans	$1,356	55%
Quartz Mcaid	$1,356	55%
UnitedHealthcare	$1,823 - $3,554	74%
Group Hlth Mcr Adv - All Plans	$2,145	87%
Independent Care Mcr - All Other Plans	$2,145	87%
Quartz Mcr Adv	$2,145	87%
Security Hp Mcr Adv	$2,145	87%
Va Ccn - All Plans	$2,145	87%
Aetna	$2,467 - $5,695	100%
Security Hp Comm - All Other Plans	$5,695	230%
Quartz Comm - All Other Plans	$6,030	244%
Humana	$6,197	251%
Cigna	$6,499	263%
The Alliance - All Plans	$9,115	369%

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 $3,852.
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 Tomah Memorial Hospital 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.