CMS Price Transparency Data
Varicella (chickenpox) vaccine
Facility: Johnson Memorial Hospital
Billing Code: 90716 (HCPCS)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90716
- Insurance Median: $380
- Cash Discount Price: $1,164
- vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Johnson Memorial Hospital is $380. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,164. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1282 Walnut Street, Dawson, MN.
Cash / Self-Pay
$1,164
Average discount available for prompt cash payment at this facility.
Insurance Median
$380
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 | $345 - $1,079 | N/A |
| Medicare (plans) | $345 - $1,079 | N/A |