CMS Price Transparency Data

Pneumococcal vaccine

Facility: Newton Medical Center

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $133
Cash Discount Price: $192
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Newton Medical Center is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 175 High St, Newton, NJ.

Cash / Self-Pay

$192

Average discount available for prompt cash payment at this facility.

Insurance Median

$133

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
Fairos [5491]	$78	N/A
Karen Ann Quinlan [5285]	$78	N/A
Aetna	$83 - $133	N/A
Amerihealth Caritas Vip Care Ip Splits [5460]	$83	N/A
Amerihealth Caritas Vip Care [5313]	$83	N/A
Champva [5354]	$83	N/A
Claimdoc [5434]	$83	N/A
Highmark Wholecare Health Plan Ip Splits [5464]	$83	N/A
Highmark Wholecare Health Plan [5413]	$83	N/A
Luminare Health AHS Retiree [5013]	$83	N/A
Medicare (plans)	$83 - $133	N/A
Sedgwick Wtc Health Program Wc [5514]	$83	N/A
Tricare	$83	N/A
UPMC [5455]	$83	N/A
Us Family Health Plan [5258]	$83	N/A
VA Community Care Network [5403]	$83	N/A
Wellcare Behavioral Health [5335]	$83	N/A
Wellcare Health Plans Ip Splits [5475]	$83	N/A
Wellcare Health Plans [5269]	$83	N/A
Kindred Giralda Hospital [5341]	$91	N/A
Cigna	$119 - $155	N/A
Blue Cross Blue Shield	$133 - $322	N/A
Wtc Health Program [5273]	$133	N/A
Medicaid / KanCare	$138	N/A
Evolution Healthcare [5438]	$140	N/A
Healthez [5445]	$140	N/A
Mvp Health Care [5197]	$140	N/A
Nalc [5198]	$140	N/A
Seafarers Health and Benefits Plan [5343]	$140	N/A
Tufts Health Plan [5344]	$140	N/A
Webtpa [5447]	$140	N/A
Horizon Nj Health [5021]	$149	N/A
Allied Benefit Systems [5046]	$155	N/A
Centivo [5405]	$155 - $349	N/A
Iaa - Insurance Administrators of America [5482]	$155	N/A
Apwu Healthcare [5053]	$163	N/A
Geha [5119]	$163	N/A
Golden Rule Insurance [5124]	$163	N/A
Harvard Pilgrim Healthcare [5133]	$163	N/A
Ntca [5208]	$163	N/A
Oxford Behavioral Health [5291]	$163	N/A
Oxford [5024]	$163	N/A
Surest [5437]	$163	N/A
UnitedHealthcare	$163	N/A
Independence Bc [5479]	$322	N/A
Prime Healthcare [5435]	$322	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 $192.
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 Newton Medical Center 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.