CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Saint Mary's Hospital

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90371
  • Insurance Median: $289
  • Cash Discount Price: $1,061
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Saint Mary's Hospital is $289. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,061. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 2.06x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$1,061

Average discount available for prompt cash payment at this facility.

Insurance Median
$289

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$140.21

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $140.21 (100%)
Cash / Self-Pay: $1,061 (757%)
Insurance Median: $289 (206%)
Cash: $1,061 (757% of Medicare)
Ins. Median: $289 (206% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $140.21 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 206% of the Medicare baseline (a markup of 106%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Carelon Behavioral Health $116 - $945 83%
Geha $116 - $945 83%
Harvard Pilgrim Healthcare $116 - $945 83%
UnitedHealthcare $116 - $1,889 83%
Blue Cross Blue Shield $123 - $793 88%
Health New England $123 - $1,002 88%
Connecticut Dept of Correction $131 - $653 93%
Aetna $135 - $629 96%
Medicare (plans) $135 - $141 96%
Cca Senior Care Options $138 98%
Cigna $139 - $1,511 99%
Bcn Domestic $158 - $793 113%
Blue Benefit Administrators of Massachusetts $158 - $793 113%
Blue Care Network $158 - $793 113%
Blue Distinction Transplant $158 - $793 113%
Blue Shield - Ca $158 - $793 113%
Blue Shield - Id (Regence) $158 - $793 113%
Blue Shield - Ny Highmark Northeastern $158 - $793 113%
Blue Shield - Ny Highmark Western $158 - $793 113%
Blue Shield - PA (Highmark) $158 - $793 113%
Blue Shield - Wa (Regence) $158 - $793 113%
Health Choices $158 - $793 113%
Kaiser Domestic $158 - $793 113%
Pre-Employment $158 - $793 113%
Unicare $158 - $793 113%
Wc Domestic $158 - $793 113%
Wellpoint $158 - $793 113%
Allied National Global Care $179 - $1,455 128%
Asrm - Reliance Standard Life Insurance $179 - $1,455 128%
Christian Care Ministry $179 - $1,455 128%
Dean Health $179 - $1,455 128%
Fallon Health $179 - $1,455 128%
Family Life Insurance Company $179 - $1,455 128%
Ghc Scw $179 - $1,455 128%
International Benefit Administrators $179 - $1,455 128%
Lifetime Benefit Solutions $179 - $1,455 128%
Manhattan Life $179 - $1,455 128%
Medi Share $179 - $1,455 128%
Multiplan $179 - $1,455 128%
Mvp $179 - $1,455 128%
PHCS $179 - $1,455 128%
Pai $179 - $1,455 128%
Pan-American Life $179 - $1,455 128%
Paramount HMO $179 - $1,455 128%
Trinity Health Share $179 - $1,455 128%
Prime Health Services $186 - $1,511 133%
Health Smart $198 - $1,606 141%
Allegiance $200 - $1,000 143%
Health Partners $200 - $1,000 143%
Magnacare $200 - $1,000 143%
United Behavioral Health Eap $233 - $1,889 166%
Centivo $276 197%
Claimdoc $289 206%
Diversified Administrators $289 206%
Innovative Health Plan II $289 206%
Connecticare $485 - $2,503 346%
1199 National Benefit Fund $629 449%
Allied Benefit Systems $629 449%
Gravie Admin Services $629 449%
Hap $629 449%
Luminare Health $629 449%
Meritain $629 449%
Nippon Life Ins $629 449%
Webtpa $629 449%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals