CMS Price Transparency Data
Flu vaccine (high dose)
Facility: St Luke's Hospital at the Vintage
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 St Luke's Hospital at the Vintage 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 20171 Chasewood Park Drive, Houston, 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
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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 |
|---|---|---|
| Renaissance | $5 - $8 | N/A |
| Aetna | $8 - $37 | N/A |
| Amerivantage | $8 - $11 | N/A |
| Blue Cross Blue Shield | $8 - $55 | N/A |
| Cigna | $8 - $82 | N/A |
| Devoted | $8 - $11 | N/A |
| Humana | $8 - $76 | N/A |
| Kelsey | $8 - $11 | N/A |
| Kindred | $8 - $12 | N/A |
| Scanhealth | $8 - $11 | N/A |
| Selectcare | $8 - $11 | N/A |
| UnitedHealthcare | $8 - $97 | N/A |
| Kelseycare | $10 - $57 | N/A |
| Community Health Choice | $11 - $16 | N/A |
| Employer Direct | $11 - $15 | N/A |
| Superior Health Plan | $11 - $16 | N/A |
| Wellpoint | $11 - $16 | N/A |
| United | $22 - $55 | N/A |
| Nx Health | $25 - $34 | N/A |
| Bright Health | $28 - $62 | N/A |
| Tchpchip | $29 - $50 | 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 - $84 | 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 |