CMS Price Transparency Data

Flu vaccine (high dose)

Facility: CHI St Lukes Lakeside Hospital

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $30
Cash Discount Price: $35
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at CHI St Lukes Lakeside Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 17400 St Lukes Way, The Woodlands, TX.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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
Renaissance	$7 - $9	N/A
Aetna	$9 - $37	N/A
Blue Cross Blue Shield	$9 - $55	N/A
Cigna	$9 - $82	N/A
Humana	$9 - $76	N/A
Kelsey	$9 - $13	N/A
Selectcare	$9 - $13	N/A
UnitedHealthcare	$9 - $97	N/A
Amerivantage	$10 - $13	N/A
Devoted	$10 - $14	N/A
Kindred	$10 - $14	N/A
Scanhealth	$10 - $14	N/A
Kelseycare	$13 - $57	N/A
Ambetter / Centene	$14 - $19	N/A
Community Health Choice	$14 - $19	N/A
Harris Health	$14 - $19	N/A
Wellpoint	$14 - $19	N/A
United	$22 - $55	N/A
Bright Health	$28 - $73	N/A
Tchpchip	$29 - $51	N/A
Nx Health	$30 - $42	N/A
Chc	$46 - $64	N/A
Texastruechoice	$46 - $64	N/A
Independent Med System	$51 - $70	N/A
Coventry	$55 - $76	N/A
First Health	$55 - $76	N/A
Healthsmart	$59 - $82	N/A
Interlink	$59 - $82	N/A
PHCS	$59 - $82	N/A
PHCS Savility	$59 - $82	N/A
Multiplan	$63 - $88	N/A
USA Health Network	$72 - $99	N/A
Mhealth Network	$84 - $117	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 $35.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90656.

Insurance In-Network Protection Plan

Contact your insurance company to confirm CHI St Lukes Lakeside Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90656.
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.