CMS Price Transparency Data

Pneumococcal vaccine

Facility: St Francis Hospital

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $86
Cash Discount Price: $193
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at St Francis Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.

Cash / Self-Pay

$193

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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	$18 - $133	N/A
Saint Francis Life	$19 - $82	N/A
Pace-Trinity Health	$19 - $82	N/A
Highmark Health Options Dual Plan	$19 - $82	N/A
Cigna	$19 - $207	N/A
Blue Shield - De (Highmark) Medciare Advantage	$19 - $82	N/A
Medicare (plans)	$20 - $88	N/A
Coventry	$24 - $101	N/A
Aetna	$24 - $217	N/A
Trustmark Small Business Benefits	$51 - $217	N/A
Meritain	$51 - $217	N/A
Galaxy Health Network	$75 - $317	N/A
Devon Health Services	$75 - $317	N/A
Wc Corvel	$75 - $317	N/A
Multiplan	$75 - $317	N/A
Prime Health Services	$75 - $317	N/A
Three Rivers Provider Network	$75 - $317	N/A
Geha	$76 - $320	N/A
UnitedHealthcare	$76 - $320	N/A
Delaware First Health	$80 - $336	N/A
Amerihealth	$124	N/A
Blue Shield - PA (Highmark)	$133	N/A
Blue Benefit Administrators of Massachusetts	$133	N/A
Blue Care Network	$133	N/A
Blue Shield - Ca	$133	N/A
Blue Shield - Id (Regence)	$133	N/A
Blue Shield - Ny Highmark Western	$133	N/A
Blue Shield - Wa (Regence)	$133	N/A
Blue Shield - Ny Highmark Northeastern	$133	N/A
Blue Distinction Transplant	$133	N/A
Medicaid / KanCare	$147	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 $193.
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 St Francis 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.