CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Gadsden Regional Medical Center

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $25
Cash Discount Price: $38
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Gadsden Regional Medical Center is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1007 Goodyear Avenue, Gadsden, AL.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

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
Blue Cross Blue Shield	$15	N/A
Node Non Par Hospice Agree	$15	N/A
Cigna	$15 - $56	N/A
Node Devoted Health McR Adv	$15	N/A
Medicare (plans)	$15 - $55	N/A
Humana	$15	N/A
Amedisys Hospice	$15	N/A
Southern Care Hospice	$15	N/A
Gadsden Hospice	$15	N/A
Node Select Health McR Adv	$15	N/A
Node VA	$15	N/A
UnitedHealthcare	$15 - $25	N/A
Node Viva McR Adv	$15	N/A
Prime Health	$16 - $185	N/A
Node Wellcare McR Adv	$16	N/A
Aetna	$16	N/A
Node Clover Health McR Adv	$16	N/A
Node Eon McR Adv	$16	N/A
Tricare	$22	N/A
Ambetter / Centene	$23	N/A
Node Champva	$23	N/A
Medicaid / KanCare	$23	N/A
Self Pay	$31 - $46	N/A
American Employee Alliance	$102	N/A
Multiplan	$146 - $161	N/A
Magellan Behavioral	$154	N/A
Viva Healthcare	$154	N/A
First Health	$179 - $207	N/A
Beech Street	$187	N/A
Alamed Wc	$192	N/A
Focus Health	$196	N/A
Coventry Work Comp Al	$200	N/A
Work Comp	$218	N/A

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 $38.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90656.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gadsden Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90656.
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.