CMS Price Transparency Data

Pneumococcal vaccine

Facility: St Joseph's University Medical Center Inc

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $218
Cash Discount Price: $562
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at St Joseph's University Medical Center Inc is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $562. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$562

Average discount available for prompt cash payment at this facility.

Insurance Median

$218

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
UnitedHealthcare	$66 - $200	N/A
Wellpoint	$110 - $221	N/A
Fidelis Care of New Jersey	$112 - $225	N/A
Aetna	$116 - $272	N/A
Blue Cross Blue Shield	$126 - $380	N/A
Amerihealth	$130 - $133	N/A
Clover Health	$133	N/A
Horizon New Jersey Total Care	$133	N/A
Oxford	$133	N/A
Horizon New Jersey Health	$141 - $282	N/A
Ambetter / Centene	$200	N/A
Multiplan	$216 - $843	N/A
Private Healthcare Systems	$216 - $731	N/A
Consumer Health Network	$249 - $1,012	N/A
Magnacare	$281 - $562	N/A
Oscar	$281 - $562	N/A
Cigna	$332 - $1,124	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 $562.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90732.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Joseph's University Medical Center Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90732.
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.