CMS Price Transparency Data

Pneumococcal vaccine

Facility: Children's Hospital of Philadelphia

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $323
Cash Discount Price: $814
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Children's Hospital of Philadelphia is $323. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $814. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$814

Average discount available for prompt cash payment at this facility.

Insurance Median

$323

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
Geisinger Medical Assistance	$14	N/A
Highmark Wholecare	$133	N/A
Horizon Nj Health	$133	N/A
Medicaid / KanCare	$134	N/A
UnitedHealthcare	$135 - $448	N/A
Health Partners	$142	N/A
Keystone Health Plan East	$174	N/A
Blue Cross Blue Shield	$174 - $287	N/A
Aetna	$214 - $407	N/A
UPMC Medical Assistance	$222	N/A
Keystone First Chip	$252	N/A
Geisinger Health Plan Commercial	$358	N/A
Jefferson Health Plans	$385	N/A
Highmark	$407	N/A
Cigna	$407	N/A
Qualcare	$448	N/A
First Health Network	$529	N/A
Private Health Care Systems	$652	N/A
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$652	N/A
Choice Care Network	$733	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 $814.
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 Children's Hospital of Philadelphia 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.