CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Davis County Hospital

Billing Code: 90656 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$34
modeled fair price · typically $19–$85
modeled estimate · not a bill or quote
Fair price $34 Cash price $30 Hospital's list price $30

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
Blue Cross Blue Shieldmajor $33 - $36 —
Aetnamajor $15 —
Amerigroup $17 - $19 —
Molina $19 —
+ 9 smaller / regional plans $16 - $28
Government programs also on file: Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

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A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals