CMS Price Transparency Data

Pneumococcal vaccine

Facility: Sanford Tracy Medical Center

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90732
  • Insurance Median: $226
  • Cash Discount Price: $216
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Pneumococcal vaccine at Sanford Tracy Medical Center is $226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 251 Fifth Street East, Tracy, MN.
Cash / Self-Pay
$216

Average discount available for prompt cash payment at this facility.

Insurance Median
$226

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

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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
Blue Cross Blue Shield $66 - $250 N/A
Sanford Health Plan Align $106 N/A
Wellmark Sd $113 N/A
Ucare $113 - $238 N/A
Medicare (plans) $114 N/A
UnitedHealthcare $114 - $226 N/A
Health Partners $114 - $216 N/A
Aetna $114 - $235 N/A
Primewest $116 - $131 N/A
Security Health Plan $149 N/A
Sanford Health Plan $214 - $251 N/A
Medica $238 - $256 N/A
Cigna $243 N/A
Healthez $243 N/A
Multiplan $243 N/A
First Choice Health Network $243 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 251 Fifth Street East, Tracy, MN 56175
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals