CMS Price Transparency Data

Hepatitis B vaccine

Facility: Portneuf Medical Center

Billing Code: 90744 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90744
Insurance Median: $90
Cash Discount Price: $132
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hepatitis B vaccine at Portneuf Medical Center is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.

Cash / Self-Pay

$132

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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
Medicare (plans)	$33 - $36	N/A
Web Tpa [2115]	$33 - $90	N/A
Triwest [3750]	$33	N/A
Blue Cross Blue Shield	$33	N/A
Humana	$35	N/A
UnitedHealthcare	$36 - $198	N/A
Aetna	$37	N/A
Hma Healthcare Manage Admin [3620]	$44	N/A
Ihs Health Services [1535]	$44	N/A
Pacific Source Health Plans [2850]	$66	N/A
Healthcare Highways [2210]	$90	N/A
Black Lung [6055]	$90	N/A
Lucent Health [6000]	$90	N/A
Employee Benefit Management Services [2445]	$90 - $132	N/A
Pending Ssi [1616]	$90	N/A
Oncology Patient Assistance Programs [2295]	$90	N/A
Moda Health [6100]	$90	N/A
Imagine Health [6025]	$98	N/A
Medishare Christian Care [1645]	$132	N/A
Multiplan [1680]	$148	N/A
Worker's Comp [2125]	$160 - $165	N/A
Enablecomp [1350]	$165	N/A
Transamerican Life [1990]	$165	N/A
Geha [1415]	$198	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 $132.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90744.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Portneuf Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90744.
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.