CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Frisbie Memorial Hospital

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90371
  • Insurance Median: $426
  • Cash Discount Price: $1,243
  • vs. Medicare Baseline: 3.04x Medicare
The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Frisbie Memorial Hospital is $426. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,243. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 3.04x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.
Cash / Self-Pay
$1,243

Average discount available for prompt cash payment at this facility.

Insurance Median
$426

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$140.21

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $140.21 (100%)
Cash / Self-Pay: $1,243 (887%)
Insurance Median: $426 (304%)
Cash: $1,243 (887% of Medicare)
Ins. Median: $426 (304% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $140.21 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 304% of the Medicare baseline (a markup of 204%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Humana $139 99%
Martin's Point Health $143 102%
Amerihealth Caritas $172 123%
Blue Cross Blue Shield $173 - $217 123%
Well Sense Health Plan $175 125%
Harvard Pilgrim $330 - $504 235%
Maine Community Health $355 - $601 253%
United $426 - $750 304%
Tufts Health Plan $426 - $711 304%
Cigna $469 334%
Aetna $718 512%
Evernorth $994 709%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11 Whitehall Road, Rochester, NH 03867
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals