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Costs of delivering babies vary widely in U.S., California cities most expensive

Newborn baby crying
BSIP | UIG | Getty Images

Congratulations on getting pregnant! — And good luck figuring out what it's going to cost to actually deliver your baby.

Delivery costs vary widely across the United States, and even within individual cities, a report released Thursday reveals.

The big differences in costs exist both for routine vaginal deliveries and for cesarean sections, according to data from Castlight Health, a health-care benefits information company that looked at prices in the nation's 30 largest metro areas.

Castlight's data shows that the average national cost for a routine vaginal delivery is $8,775. The national average for c-sections is $11,525, according to the report, which defined price as what an employer-sponsored health plan paid for the delivery plus what the covered person paid out-of-pocket.

But there's plenty of prices for each kind of delivery that are nowhere near those averages — mirroring a phenomenon seen elsewhere in health-care procedures, including the common surgeries of knee and hip replacements, where very wide variations in costs have been documented.

Castlight Health's home city of San Francisco had the highest observed price for a routine vaginal delivery, a whopping $28,541.

Another city in California, San Diego, had the lowest observed price for a routine delivery — just $3,243.

The highest average prices for vaginal deliveries likewise were in California, in Sacramento, where the average was $15,420. San Francisco's average was a close second, at $15,204.

Those eye-popping averages compare to an average price of $8,857 for vaginal deliveries in Charlotte, North Carolina, which holds 16th place for U.S. cities for its price for that type of delivery.

The least expensive city for routine vaginal deliveries was Kansas City, Missouri, where the average price was $6,075.

The disparities were even bigger when Castlight looked at the costs of c-sections.

Los Angeles had the top price observed for c-sections: $42,530.

The lowest price for a c-section was seen in Pittsburgh, Pennsylvania, where it cost $4,419 — nearly 10 times less than L.A.

For average prices for c-sections, Sacramento again had the most expensive average price, at $27,067. San Francisco again held second place, with an average of $21,799.

Orlando, Florida, had an average c-section price of $12,232, putting it in the middle of the pack for the cities examined.

The lowest average price was in Pittsburgh, at $6,891 — which was four times less than Sacramento's average.

While c-sections tend to be more expensive than vaginal deliveries, Castlight found that the average c-section in Cleveland, which cost $8,772, was less expensive than what routine vaginal deliveries cost in 17 of the 30 cities looked at.

Castlight's report said that the "shockingly higher" average prices in cities such as Sacramento and San Francisco are related to the consolidation of health providers in those places, resulting in less competition for patients.

But San Francisco also was one of the cities which has a very wide range of prices for deliveries.

Castlight said the lowest cost seen for a c-section delivery in San Francisco was $8,399, which was five times less than the highest cost seen in the city, $41,191.

In Los Angeles, the lowest cost for a c-section, at $6,232, was nearly seven times less than the highest cost c-section, at $42,530.

There was a price difference of more than six times between the lowest price for a routine vaginal delivery in Los Angeles, at $4,223, and the highest price, at $27,326.

In New York City, there was more than a four-times difference between the lowest prices for a routine vaginal delivery, $4,022, and the highest price, at $17,646, according to Caslight's data.

"The fact that these huge price differences exist for maternity care is deplorable," said Kristin Torres Mowat, senior vice president of plan development and data operations at Castlight Health. "The price variances seen in both routine and cesarean deliveries reflect the large systemic problems in our nation's health-care system."