CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Ochsner Stennis Memorial Hospital

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $136
Cash Discount Price: $158
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Ochsner Stennis Memorial Hospital is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$136

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
Humana	$91 - $155	N/A
Prime Health Services PPO -Workers Comp	$95	N/A
Cor Vel	$96 - $97	N/A
Claritev D/B/A Multiplan/Phcs/American Life Care	$106 - $168	N/A
Blue Cross Blue Shield	$114 - $127	N/A
UnitedHealthcare	$114 - $207	N/A
Cigna	$128 - $205	N/A
Medicare (plans)	$134 - $155	N/A
Ambetter / Centene	$136	N/A
Magnolia Health Plan – Wellcare By All Well of Mississippi	$136	N/A
Medicaid / KanCare	$136 - $143	N/A
Shared Health Mississippi	$141	N/A
Aetna	$146 - $207	N/A
Primewell Health Services Commercial Exchange Plan	$150	N/A
Primewell Health Services – Commercial	$150	N/A
Zelis	$153 - $168	N/A
Select Administrative Services Network	$157 - $164	N/A
Prime Health Services PPO	$179	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 $158.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90716.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner Stennis Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90716.
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.