CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Mercy Hospital of Buffalo

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90371
Insurance Median: $144
Cash Discount Price: $272
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Mercy Hospital of Buffalo is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $272. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 1.03x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.

Cash / Self-Pay

$272

Average discount available for prompt cash payment at this facility.

Insurance Median

$144

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$140.21

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $140.21 (100%)

Cash / Self-Pay: $272 (194%)

Insurance Median: $144 (103%)

Cash: $272 (194% of Medicare)

Ins. Median: $144 (103% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $140.21 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

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
Univera Healthcare [100169]	$141 - $146	101%
UnitedHealthcare	$141 - $192	101%
VA Veterans Affairs [700001]	$141	101%
Iha First Choice [800001]	$141	101%
Independent Health Essential [100166]	$141	101%
Independent Health [100165]	$141	101%
Medicaid / KanCare	$141 - $144	101%
Humana	$141	101%
Univera Healthcare Essential [100170]	$141	101%
Medicare (plans)	$141 - $144	101%
Covid19 Hrsa [45013]	$144	103%
Seneca Nation [450119]	$144	103%
Molina Essential [100167]	$144	103%
Cigna	$144	103%
Fallon Health [450115]	$144	103%
Hospice [550001]	$144	103%
Wellcare [450129]	$158	113%
Blue Cross Blue Shield	$163	116%
UPMC Health Plan [100181]	$164 - $834	117%
Ghi [100153]	$187	133%
No Fault [114001]	$508	362%
Federal Workers Compensation [500100]	$508	362%

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 $272.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90371.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital of Buffalo is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90371.
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.