CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Lafayette Regional Health Center

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $19
Cash Discount Price: $31
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Lafayette Regional Health Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1500 State Street, Lexington, MO.

Cash / Self-Pay

$31

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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 (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Ambetter / Centene	$6	N/A
Aetna	$8 - $28	N/A
United	$8 - $38	N/A
Humana	$10 - $14	N/A
Blue Cross Blue Shield	$11 - $20	N/A
Oscar	$15 - $16	N/A
Oha Network	$15 - $16	N/A
Cigna	$17 - $23	N/A
Unicare	$23	N/A
Healthyblue	$23	N/A
Home State Health Plan	$23	N/A
Wppa Providrs Care Network	$23 - $24	N/A
Medicaid / KanCare	$23	N/A
Multiplan	$23 - $25	N/A
Amerigroup	$23	N/A
Coventry Kc Mo	$24 - $25	N/A
Coventry	$24 - $25	N/A
Corvel Corporation	$26 - $27	N/A
Cco, Inc.	$26 - $27	N/A
Focus Healthcare Mgmt, Inc	$27 - $28	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 $31.
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 Lafayette Regional Health 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.