CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Trinity - Bettendorf

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90371
Insurance Median: $143
Cash Discount Price: $212
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Trinity - Bettendorf is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $212. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 1.02x the Medicare baseline. Located in 4500 Utica Ridge Road, Bettendorf, IA.

Cash / Self-Pay

$212

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $212 (151%)

Insurance Median: $143 (102%)

Cash: $212 (151% of Medicare)

Ins. Median: $143 (102% 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.

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
Health Partners Open Network	$67 - $230	48%
Medica Exchange Inspire	$87 - $93	62%
Medica Exchange Insure	$97 - $104	69%
Cigna	$130 - $179	93%
Aetna	$133 - $239	95%
Blue Cross Blue Shield	$133 - $143	95%
Health Alliance	$133	95%
UnitedHealthcare	$137 - $162	98%
Humana	$137	98%
Meridian Health Plan	$137	98%
Wellmark Uph Self-Funded	$143	102%
Ambetter / Centene	$209	149%

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 $212.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90371.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Trinity - Bettendorf is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90371.
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.