CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Garrett Regional Medical Center

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $53
Cash Discount Price: Unavailable
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Garrett Regional Medical Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 251 North Fourth Street, Oakland, MD.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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
Caresource Wv	$50	N/A
Humana	$51	N/A
Provider Partners	$51	N/A
Carefirst PPO	$51	N/A
Senior Advantage	$51	N/A
UnitedHealthcare	$51 - $56	N/A
Carefirst D-Snp	$51	N/A
Medicare (plans)	$51	N/A
United Mine Workers of America	$51 - $56	N/A
Aetna	$51 - $56	N/A
Maryland Physicians Care	$53	N/A
Coventry	$53	N/A
Multiplan	$53	N/A
Wellpoint Wv	$53	N/A
The Health Plan of Wv	$53	N/A
Amerigroup	$53	N/A
Highmark Health Options Wv	$53	N/A
Carefirst Community Health Plan	$53	N/A
UPMC Commercial	$55	N/A
First Health	$56	N/A
John Hopkins Healthcare	$56	N/A
The Health Plan	$56	N/A
The Health Plan Commercial	$56	N/A
Cigna	$56	N/A
Stratose/ 4 Most	$56	N/A
Peak Commercial	$56	N/A
American Correctional Healthcare	$56	N/A
Alliance Coal	$56	N/A
Carefirst Commercial	$56	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 $X.
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 Garrett Regional Medical Center 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.