CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Chilton Medical Center

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $103
Cash Discount Price: $210
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Chilton Medical Center is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 97 West Parkway, Pompton Plains, NJ.

Cash / Self-Pay

$210

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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
Evolution Healthcare [5438]	$20	N/A
Seafarers Health and Benefits Plan [5343]	$20	N/A
Nalc [5198]	$20	N/A
Webtpa [5447]	$20	N/A
Healthez [5445]	$20	N/A
Cigna	$20 - $22	N/A
Tufts Health Plan [5344]	$20	N/A
Mvp Health Care [5197]	$20	N/A
Medicare (plans)	$22 - $155	N/A
Wtc Health Program [5273]	$22	N/A
Aetna	$22 - $209	N/A
Blue Cross Blue Shield	$22	N/A
Ntca [5208]	$27	N/A
UnitedHealthcare	$27	N/A
Oxford Behavioral Health [5291]	$27	N/A
Apwu Healthcare [5053]	$27	N/A
Golden Rule Insurance [5124]	$27	N/A
Surest [5437]	$27	N/A
Harvard Pilgrim Healthcare [5133]	$27	N/A
Oxford [5024]	$27	N/A
Geha [5119]	$27	N/A
Carelon Behavioral Health [5508]	$40	N/A
Horizon Nj Health [5021]	$45	N/A
Karen Ann Quinlan [5285]	$82	N/A
Fairos [5491]	$83	N/A
VA Community Care Network [5403]	$103	N/A
Luminare Health AHS Retiree [5013]	$103	N/A
Kindred Giralda Hospital [5341]	$113	N/A
Tricare	$114 - $118	N/A
Specialty Imaging [5433]	$118	N/A
Champva [5354]	$118	N/A
Cosmetic Surgery/Lap Band/Gastric Bypass [5289]	$118	N/A
Us Family Health Plan [5258]	$118	N/A
Medicaid / KanCare	$118	N/A
Sedgwick Wtc Health Program Wc [5514]	$128	N/A
Wellcare Health Plans Ip Splits [5475]	$150	N/A
UPMC [5455]	$150	N/A
Wellcare Behavioral Health [5335]	$150	N/A
Highmark Wholecare Health Plan Ip Splits [5464]	$150	N/A
Highmark Wholecare Health Plan [5413]	$150	N/A
Wellcare Health Plans [5269]	$150	N/A
Amerihealth Caritas Vip Care Ip Splits [5460]	$151	N/A
Amerihealth Caritas Vip Care [5313]	$151	N/A
Amerihealth [5008]	$192	N/A
Amerihealth Administrators Supplemental [5512]	$192	N/A
Amerihealth Medigap [5049]	$192	N/A
Claimdoc [5434]	$227	N/A
Kessler Foundation [5532]	$12,000	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 $210.
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 Chilton Medical 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.