CMS Price Transparency Data

Pneumococcal vaccine

Facility: Saint Mary's Hospital

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $153
Cash Discount Price: $334
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Saint Mary's Hospital is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $334. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.

Cash / Self-Pay

$334

Average discount available for prompt cash payment at this facility.

Insurance Median

$153

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
Aetna	$56	N/A
Blue Cross Blue Shield	$56 - $153	N/A
Medicare (plans)	$56 - $129	N/A
UnitedHealthcare	$56 - $334	N/A
Cca Senior Care Options	$57	N/A
Cigna	$57 - $267	N/A
Centivo	$113	N/A
Claimdoc	$119	N/A
Diversified Administrators	$119	N/A
Innovative Health Plan II	$119	N/A
Connecticut Dept of Correction	$133	N/A
Allegiance	$148	N/A
Health Partners	$148	N/A
Magnacare	$148	N/A
Bcn Domestic	$153	N/A
Blue Benefit Administrators of Massachusetts	$153	N/A
Blue Care Network	$153	N/A
Blue Distinction Transplant	$153	N/A
Blue Shield - Ca	$153	N/A
Blue Shield - Id (Regence)	$153	N/A
Blue Shield - Ny Highmark Northeastern	$153	N/A
Blue Shield - Ny Highmark Western	$153	N/A
Blue Shield - PA (Highmark)	$153	N/A
Blue Shield - Wa (Regence)	$153	N/A
Health Choices	$153	N/A
Kaiser Domestic	$153	N/A
Pre-Employment	$153	N/A
Unicare	$153	N/A
Wc Domestic	$153	N/A
Wellpoint	$153	N/A
Carelon Behavioral Health	$167	N/A
Geha	$167	N/A
Harvard Pilgrim Healthcare	$167	N/A
Health New England	$177	N/A
Allied National Global Care	$257	N/A
Asrm - Reliance Standard Life Insurance	$257	N/A
Christian Care Ministry	$257	N/A
Dean Health	$257	N/A
Fallon Health	$257	N/A
Family Life Insurance Company	$257	N/A
Ghc Scw	$257	N/A
International Benefit Administrators	$257	N/A
Lifetime Benefit Solutions	$257	N/A
Manhattan Life	$257	N/A
Medi Share	$257	N/A
Multiplan	$257	N/A
Mvp	$257	N/A
PHCS	$257	N/A
Pai	$257	N/A
Pan-American Life	$257	N/A
Paramount HMO	$257	N/A
Trinity Health Share	$257	N/A
Prime Health Services	$267	N/A
Health Smart	$284	N/A
United Behavioral Health Eap	$334	N/A
Connecticare	$400 - $413	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 $334.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90732.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Saint Mary's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90732.
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.