CMS Price Transparency Data

Hepatitis B vaccine

Facility: Frisbie Memorial Hospital

Billing Code: 90744 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90744
Insurance Median: $87
Cash Discount Price: $260
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hepatitis B vaccine at Frisbie Memorial Hospital is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$260

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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
Amerihealth Caritas	$21	N/A
Humana	$31	N/A
Martin's Point Health	$32	N/A
Well Sense Health Plan	$32	N/A
Blue Cross Blue Shield	$42 - $52	N/A
Harvard Pilgrim	$69 - $105	N/A
Maine Community Health	$74 - $126	N/A
Cigna	$87	N/A
United	$89 - $157	N/A
Tufts Health Plan	$89 - $149	N/A
Aetna	$150	N/A
Evernorth	$208	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 $260.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90744.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Frisbie Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90744.
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.