CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 90371 (HCPCS)

The BaseRate · fair price high confidence

A fair price for this

$186

about 1.3× the $140 Medicare rate · typically $142–$343

modeled estimate · not a bill or quote

What this hospital charges insurers

$155

Below the fair price — a good deal

about $31 under the fair price · 1.1× Medicare

Medicare pays $140 Fair price $186 This hospital $155

How we calculate the fair BaseRate →

How this hospital compares to other NH hospitals

One of the lower prices — 7 of 8 other NH hospitals charge more for the same procedure.

Cheapest $135 Priciest $237

Black dot = this hospital, among the 9 NH hospitals with a price for this procedure. Full list below.

A fair price for a Hepatitis B immune globulin is about $186 (about 1.3× the $140 Medicare rate). Mary Hitchcock Memorial Hospital charges insurers about $155 — below the fair price — a good deal. Located in Lebanon, NH.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$128 - $556	91%
Blue Cross Blue Shieldmajor	$134 - $1,030	96%
Aetnamajor	$126 - $198	90%
Cignamajor	$138 - $324	98%
Ambetter (Centene)	$141 - $441	101%
AmeriHealth	$172 - $822	123%
Harvard Pilgrim	$95 - $521	68%
MVP Health Care	$134 - $162	96%
Tufts Health Plan	$135 - $150	96%
WellCare	$140	100%
WellSense	$135 - $822	96%
+ 5 smaller / regional plans	$134 - $822

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the HCPCS code on your bill matches exactly: 90371.

Insurance Before you use insurance

Call your insurance company to confirm Mary Hitchcock Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for HCPCS code 90371.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mary Hitchcock Memorial Hospital

Compare: Hepatitis B immune globulin at other NH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.