CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: St Francis Hospital & Medical Center

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $392
Cash Discount Price: $590
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at St Francis Hospital & Medical Center is $392. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $590. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 114 Woodland Street & 500 Blue Hills Avenue, Hartford, CT.

Cash / Self-Pay

$590

Average discount available for prompt cash payment at this facility.

Insurance Median

$392

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 (%)

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicare (plans)	$126 - $1,098	N/A
Connecticut Dept of Correction	$130 - $248	N/A
Unicare	$158 - $302	N/A
Wellpoint	$158 - $302	N/A
Aetna	$193 - $754	N/A
Connecticare	$217 - $264	N/A
1199 National Benefit Fund	$241	N/A
Allied Benefit Systems	$241	N/A
Gravie Admin Services	$241	N/A
Hap	$241	N/A
Luminare Health	$241	N/A
Meritain	$241	N/A
Nippon Life Ins	$241	N/A
Webtpa	$241	N/A
Allegiance	$243	N/A
Cigna	$243 - $878	N/A
Health Partners	$243	N/A
Magnacare	$243	N/A
Geha	$286 - $545	N/A
Harvard Pilgrim Healthcare	$286 - $545	N/A
UnitedHealthcare	$286 - $546	N/A
Health New England	$318 - $606	N/A
Innovative Health Plan II	$346 - $659	N/A
Allied National Global Care	$392 - $747	N/A
Asrm - Reliance Standard Life Insurance	$392 - $747	N/A
Christian Care Ministry	$392 - $747	N/A
Dean Health	$392 - $747	N/A
Family Life Insurance Company	$392 - $747	N/A
Ghc Scw	$392 - $747	N/A
International Benefit Administrators	$392 - $747	N/A
Lifetime Benefit Solutions	$392 - $747	N/A
Manhattan Life	$392 - $747	N/A
Medi Share	$392 - $747	N/A
Multiplan	$392 - $747	N/A
Mvp	$392 - $747	N/A
PHCS	$392 - $747	N/A
Pai	$392 - $747	N/A
Pan-American Life	$392 - $747	N/A
Paramount HMO	$392 - $747	N/A
Trinity Health Share	$392 - $747	N/A
Prime Health Services	$403 - $769	N/A
Centivo	$432 - $824	N/A
Health Smart	$490 - $933	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 $590.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90716.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Francis Hospital & Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90716.
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.