CMS Price Transparency Data

Pneumococcal vaccine

Facility: Ohio Valley Surgical Hospital

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $162
Cash Discount Price: $42
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Ohio Valley Surgical Hospital is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 100 West Main Street, Springfield, OH.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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
Mmoh	$31 - $32	N/A
Mmoh (Supermed)	$32	N/A
Mmo Cin. HMO	$32	N/A
Medicare (plans)	$42	N/A
Ohio Health	$63	N/A
Preferred Health	$63	N/A
Medben	$63	N/A
Luminare Health	$63	N/A
Blue Cross Blue Shield	$69	N/A
Pacific Source	$162	N/A
Meritain	$162	N/A
Mhbp	$162	N/A
Aetna	$162	N/A
Nippon Life	$162	N/A
Personify Health	$162	N/A
Meritain Heatlh	$162	N/A
Genworth	$162	N/A
Geha	$162	N/A
Mail Handlers	$162	N/A
Ngs Coresource	$162	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 $42.
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 Ohio Valley Surgical Hospital 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.