CMS Price Transparency Data

Pneumococcal vaccine

Facility: Hospital for Special Surgery

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $124
Cash Discount Price: $211
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Hospital for Special Surgery is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 535 East 70Th Street, New York, NY.

Cash / Self-Pay

$211

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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
Aetna	$66 - $154	N/A
Blue Cross Blue Shield	$70 - $180	N/A
Metro Plus	$70	N/A
Wellfleet [1361]	$109 - $126	N/A
Nalc [1090]	$109 - $126	N/A
Cigna	$109 - $126	N/A
Apwu [1016]	$109 - $126	N/A
Qualcare [1101]	$109 - $126	N/A
Nyship	$117	N/A
Emblem Health [1043]	$124 - $220	N/A
Connecticare [1039]	$124 - $128	N/A
UnitedHealthcare	$127 - $220	N/A
Horizon	$129	N/A
Meritain Health [1085]	$148 - $154	N/A
Christian Brothers [1034]	$148 - $154	N/A
Nippon Life [1092]	$148 - $154	N/A
Webtpa [1356]	$148 - $154	N/A
Affinity By Molina Health Plan [1005]	$154 - $160	N/A
Geha [1053]	$220	N/A
Oxford [1096]	$220	N/A
Harvard Pilgrim [1057]	$220	N/A
Student Resources [1103]	$220	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 $211.
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 Hospital for Special Surgery 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.