C-section delivery (full package)
Facility: Regional Medical Center
Billing Code: 59510 (CPT)
- CPT Billing Code: 59510
- Insurance Median: $870
- Cash Discount Price: $5,529
- vs. Medicare Baseline: 0.35x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 35% |
Consumer Guidance & Cost Commentary
For C-section delivery services at Regional Medical Center in Manchester, Iowa, the facility's cash payment rate of $5,529 is notably lower than its gross charge of $6,911, offering a potential savings for patients paying out-of-pocket. While the facility's Medicare benchmark amount of $2,473.27 serves as the federal baseline for this procedure, the cash price exceeds the Medicare rate by approximately 223%, which is significantly higher than the typical fair pricing range of 120% to 150% of Medicare. It is important to note that this cash rate applies only to self-pay patients and does not reflect the negotiated rates of $870 paid by the single commercial payer, Medical Associates Health Plan - Tri, or the median negotiated rate of $870 observed in the state.
Patients should be aware that cash payments can sometimes be more cost-effective than insurance claims if the patient's plan has a high deductible or if the insurance negotiated rate exceeds the cash price, though in this specific case, the cash rate is higher than the commercial negotiated rate. To secure the lowest possible price, consumers are encouraged to explicitly ask the hospital for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. If a patient chooses to use insurance, they must verify their deductible status and ensure they understand that the $870 rate is the maximum allowed under contract; any balance billed beyond this amount would be unexpected and potentially illegal under the No Surprises Act for services at an in-network facility.