CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Ira Davenport Memorial Hospital

Billing Code: 90716 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$196
modeled fair price · typically $61–$268
modeled estimate · not a bill or quote
Fair price $196 Cash price $154 Hospital's list price $154

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $115 —
Blue Cross Blue Shieldmajor $67 - $467 —
Aetnamajor $115 —
Cignamajor $96 —
Humanamajor $139 —
Fidelis Care $85 —
Geisinger $90 —
Independent Health $100 —
MVP Health Care $96 —
UPMC Health Plan $106 —
+ 5 smaller / regional plans $111 - $507

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 7571 State Route 54, Bath, NY 14810
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Rural Emergency Hospital