CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Fishermen's Community Hospital

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $30
Cash Discount Price: $34
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Fishermen's Community Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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	$9 - $53	N/A
UnitedHealthcare	$11 - $53	N/A
Leon Medical	$11	N/A
Medica Health Plan	$11	N/A
Medicare (plans)	$11 - $15	N/A
Aetna	$12 - $41	N/A
Avmed	$12 - $44	N/A
Humana	$12	N/A
Cigna	$13 - $42	N/A
Amerigroup	$16	N/A
Wellcare	$16	N/A
Medicaid / KanCare	$16 - $17	N/A
Vista	$17	N/A
Sunshine State	$17	N/A
Non Contracted	$19	N/A
International	$34	N/A
Amerihealth	$40	N/A
Dimension Health Plan	$40 - $48	N/A
Quality Health	$48	N/A
Affordable	$48	N/A
PHCS	$48	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 $34.
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 Fishermen's Community Hospital 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.