Vaginal delivery (full package)
Facility: Regional Medical Center
Billing Code: 59400 (CPT)
- CPT Billing Code: 59400
- Insurance Median: $870
- Cash Discount Price: $4,984
- vs. Medicare Baseline: 0.39x 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 $2,214.42 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.
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 | 39% |
Consumer Guidance & Cost Commentary
If you are considering paying out-of-pocket for a vaginal delivery at Regional Medical Center, you should know that the cash median rate is $4,984.00. For patients with high-deductible plans or those without insurance, this cash price may be lower than the negotiated rate of $870.00 charged by Medical Associates Health Plan - Tri, which is the only payer in this dataset. It is important to note that while cash rates appear lower here, patients should always verify if their specific insurance plan covers the service, as some commercial contracts may exceed the cash amount, making the negotiated rate more favorable for insured individuals.
The facility's pricing context is further defined by its relationship to government and Medicare benchmarks. As a government-owned Critical Access Hospital in Manchester, Iowa, the facility's gross charge for this procedure is $6,230.00, while the Medicare amount is set at $2,214.42. The data indicates a ratio (vs_medicare) of 0.4, suggesting the negotiated rate is significantly lower than the gross list price. Although specific state or county average comparisons are not provided in the current data, patients should be aware that hospitals often list inflated chargemaster prices to make discounts appear larger; therefore, comparing rates against the Medicare benchmark of $2,214.42 offers a more accurate view of the facility's cost structure than the initial gross charge.