CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Kenmore Mercy Hospital

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $192
Cash Discount Price: $176
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Kenmore Mercy Hospital is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.

Cash / Self-Pay

$176

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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
No Fault [114001]	$52	N/A
Federal Workers Compensation [500100]	$52	N/A
UnitedHealthcare	$174 - $209	N/A
VA Veterans Affairs [700001]	$174 - $184	N/A
Medicare (plans)	$178 - $199	N/A
Iha First Choice [800001]	$178 - $192	N/A
Independent Health [100165]	$178 - $192	N/A
Medicaid / KanCare	$178 - $192	N/A
Independent Health Essential [100166]	$178 - $192	N/A
Univera Healthcare [100169]	$183	N/A
Univera Healthcare Essential [100170]	$183 - $220	N/A
Humana	$199	N/A
Blue Cross Blue Shield	$229 - $384	N/A
Ghi [100153]	$230	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 $176.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90716.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kenmore Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90716.
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.