CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Lost Rivers Medical Center

Billing Code: 90371 (HCPCS)

The BaseRate · fair price low confidence
A fair price for this
$307
about 2.2× the $140 Medicare rate · typically $134–$1,364
modeled estimate · not a bill or quote
Medicare pays $140 Fair price $307 Cash price $1,040 Hospital's list price $1,300

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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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
UnitedHealthcaremajor $1,235 881%
Blue Cross Blue Shieldmajor $819 - $1,300 584%
Aetnamajor $884 - $1,222 630%
Cignamajor $1,209 862%
Humanamajor $819 - $1,300 584%
Molina $819 584%
PacificSource $819 - $1,235 584%
SelectHealth $819 584%
+ 5 smaller / regional plans $252 - $1,261
Government programs also on file: Military & VA.
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 551 Highland Drive, Arco, ID 83213
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals