CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Mid-Columbia Medical Center

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90371
  • Insurance Median: $428
  • Cash Discount Price: $1,013
  • vs. Medicare Baseline: 3.05x Medicare
The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Mid-Columbia Medical Center is $428. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,013. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 3.05x the Medicare baseline. Located in 1700 E 19Th Street, The Dalles, OR.
Cash / Self-Pay
$1,013

Average discount available for prompt cash payment at this facility.

Insurance Median
$428

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: $1,013 (722%)
Insurance Median: $428 (305%)
Cash: $1,013 (722% of Medicare)
Ins. Median: $428 (305% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 305% of the Medicare baseline (a markup of 205%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $140 - $12,025 100%
Community Hp McR Adv - All Plans $140 100%
Moda McR Adv $140 100%
Molina McR Adv $140 100%
Tricare $140 100%
VA Ccn Triwest - All Plans $140 100%
Healthnet McR Adv $143 102%
Humana $147 105%
Molina - All Other Plans $154 110%
Norocor - All Plans $225 - $1,886 160%
Amerigroup McAid - All Plans $234 - $1,961 167%
Coordinated Care McAid - All Plans $234 - $1,961 167%
Molina McAid $234 - $1,961 167%
UnitedHealthcare $234 - $3,583 167%
Employee Health Plan - All Plans $252 180%
Moda Health Plan - All Other Plans $297 - $2,489 212%
Healthscape - All Plans $360 - $3,017 257%
First Health - All Plans $401 - $2,500 286%
Coventry - All Plans $405 - $3,394 289%
Aetna $416 - $3,481 297%
Cigna $424 - $3,553 302%
First Choice - All Plans $428 - $3,583 305%
Multiplan/Phcs - All Plans $428 - $3,583 305%
Providence PPO - All Plans $428 - $3,583 305%
Trpn - Three Rivers - All Plans $428 - $3,583 305%
Ahp - Americas Hlth Plan - All Plans $437 - $3,658 312%
Devoted McR Adv - All Plans $486 - $4,073 347%
Pacific Source - All Plans $540 - $4,526 385%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 E 19Th Street, The Dalles, OR 97058
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals