CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $63
Cash Discount Price: $92
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at UPMC Children's Hospital of Pittsburgh is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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 (%)

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
UPMC Health Plan	$23 - $80	N/A
Aetna	$29 - $215	N/A
Health Partners Plans (Jefferson Health Plan)	$39	N/A
UnitedHealthcare	$40 - $867	N/A
Geisinger	$41 - $52	N/A
PA Health & Wellness	$46	N/A
Amerihealth Caritas	$47	N/A
Blue Cross Blue Shield	$52 - $78	N/A
Highmark Wholecare (Prev Gateway)	$52	N/A
Cigna	$54 - $63	N/A
Intergroup	$75 - $98	N/A
Health Plan of Upper Ohio Valley	$75 - $208	N/A
Saudi Armed Forces	$92	N/A
Coventry/First Health	$92	N/A
Health Payors Organization	$98	N/A
Multiplan	$98	N/A
National Provider Network	$104	N/A
Private Health Care Systems	$104	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 $92.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90716.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Children's Hospital of Pittsburgh is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90716.
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.