CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Medical City Alliance

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90371
Insurance Median: $954
Cash Discount Price: $7,066
vs. Medicare Baseline: 6.80x Medicare

The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Medical City Alliance is $954. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,066. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 6.80x the Medicare baseline. Located in 3101 North Tarrant Parkway, Fort Worth, TX.

Cash / Self-Pay

$7,066

Average discount available for prompt cash payment at this facility.

Insurance Median

$954

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: $7,066 (5040%)

Insurance Median: $954 (680%)

Cash: $7,066 (5040% of Medicare)

Ins. Median: $954 (680% 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 680% of the Medicare baseline (a markup of 580%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$139 - $804	99%
Triwest Health Alliance	$143	102%
United	$227 - $1,604	162%
Blue Cross Blue Shield	$444 - $3,137	317%
Superior Health Plan	$495	353%
Aetna	$954 - $5,137	680%
Cigna	$954 - $1,514	680%
Healthcare Highways	$2,388	1703%
Healthsmart Preferred Care	$5,300	3780%
Independent Medical Systems	$7,066	5040%
National Healthcare Solutions	$7,066	5040%

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 $7,066.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90371.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical City Alliance is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90371.
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.