National Median In-Network Amount for C-section Rose Nine Percent, from Less Than $16,000 in September 2022 to Nearly $17,000 in September 2023

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National Median In-Network Amount for C-section Rose Nine Percent, from Less Than $16,000 in September 2022 to Nearly $17,000 in September 2023

PR Newswire

Alaska Has Highest Median In-Network Amount for Vaginal Delivery, New Jersey for C-section, according to FAIR Health Cost of Giving Birth Tracker

NEW YORK, June 13, 2024 /PRNewswire/ -- The national median allowed amount for C-section rose 8.9 percent, from $15,555.61 in September 2022 to $16,943.79 in September 2023, according to the FAIR Health Cost of Giving Birth Tracker. The national median allowed amount for vaginal delivery rose 7.5 percent, from $12,968.44 in September 2022 to $13,945.72 in September 2023.

Available on FAIR Health's website fairhealth.org, the Cost of Giving Birth Tracker is a free, interactive tool tracking the cost of giving birth state by state. It consists of heat maps that show state-specific and national median1 charge and allowed (in-network) amounts2 for vaginal deliveries and C-sections. The tool draws on the national, independent nonprofit FAIR Health's database of over 46 billion commercial healthcare claim records—the largest such repository in the country. Launched in June 2023 with data from September 2022, the Cost of Giving Birth Tracker has just been updated with data from the September 2023 release of the vaginal delivery and C-section FH® Total Treatment Cost benchmarks.

The Tracker includes inpatient and outpatient facility and professional costs. Services include the delivery itself (e.g., pharmacy, nursery, labor and delivery room, medical and surgical supplies, room and board for the mother), anesthesia, fetal nonstress tests, ultrasounds, laboratory work and a breast pump.

Among the findings of the newly updated Cost of Giving Birth Tracker:

  • In September 2023, Alaska was the state with the highest median allowed amount for vaginal deliveries, $23,403.48, followed by (in order from highest to lowest) New Jersey, Connecticut, Nevada and California. In September 2022, three of these five states were also on this list (Alaska, New Jersey and Connecticut), but the list also included New York and Massachusetts. See table 1.
  • In September 2023, New Jersey was the state with the highest median allowed amount for C-sections, $26,876.00, followed by Alaska, New York, California and Connecticut. In September 2022, the same five states were on this list, though in different order: Alaska was highest, followed by New Jersey, New York, Connecticut and California. See table 2.
  • In September 2023, Louisiana had the lowest median allowed amount for vaginal deliveries, $8,922.94, followed by (in order from lowest to highest) Alabama, Missouri, Oklahoma and Kentucky. In September 2022, two of these five states were also on this list (Alabama and Louisiana, though Alabama was lowest), but the list also included Maryland, Virginia and West Virginia. See table 3.
  • In September 2023, Louisiana had the lowest median allowed amount for C-sections, $10,124.35, followed by Alabama, Missouri, Maryland and Oklahoma. In September 2022, the same five states were on this list, though in different order: Alabama was lowest, followed by Louisiana, Maryland, Missouri and Oklahoma. See table 4.

The Cost of Giving Birth Tracker is one of FAIR Health's series of trackers offering geographic windows into healthcare data. The series also includes the Monthly Telehealth Regional Tracker, which tracks telehealth utilization by region across the nation, and the Opioid Tracker, which tracks opioid abuse and dependence.

FAIR Health President Robin Gelburd stated: "FAIR Health is pleased to continue illuminating the costs of giving birth from state to state and nationally. With the updated Cost of Giving Birth Tracker, we again use our vast data repository to inform healthcare stakeholders—including patients, policy makers, payors, providers and researchers—on issues that matter to them."

For the Cost of Giving Birth Tracker, click here.

Follow us on X @FAIRHealth

About FAIR Health
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of commercial healthcare claims data, which includes over 46 billion claim records and is growing at a rate of over 3 billion claim records a year. FAIR Health licenses its commercial data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D, which accounts for a separate collection of over 47 billion claim records; FAIR Health includes among the commercial claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 Type 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. For more information on FAIR Health, visit fairhealth.org.

Contact:
Rachel Kent
Executive Director of Communications and Marketing
FAIR Health
646-396-0795
[email protected]

1 A median is the midpoint of the distribution of values below and above which there is an equal number of values.
2 A charge amount is the amount charged to a patient who is uninsured or obtaining an out-of-network service. An allowed amount is the total fee negotiated between an insurance plan and a provider for an in-network service, including both the portion to be paid by the plan member and the portion to be paid by the plan.

 

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