CMS Price Transparency Data

Hepatitis B vaccine

Facility: Ira Davenport Memorial Hospital

Billing Code: 90744 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90744
Insurance Median: $52
Cash Discount Price: $77
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hepatitis B vaccine at Ira Davenport Memorial Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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
Blue Cross Blue Shield	$33 - $233	N/A
Empire	$35	N/A
Fidelis Care - Exchange - All Plans	$42	N/A
Geisinger - All Plans	$45	N/A
Mvp Health Plan - All Plans	$48	N/A
Cigna	$48	N/A
Independent Health - All Plans	$50	N/A
Aetna	$50 - $58	N/A
UPMC - All Plans	$53	N/A
Pomco Inc - All Plans	$55	N/A
UnitedHealthcare	$58	N/A
Emblem Health - All Plans	$68	N/A
Humana	$69	N/A
Martins Point - All Plans	$77	N/A
Healthnow - All Plans	$253	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 $77.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90744.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ira Davenport Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90744.
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.