CMS Price Transparency Data

Hepatitis B vaccine

Facility: CHI St Lukes Health Memorial San Augustine

Billing Code: 90744 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90744
Insurance Median: $394
Cash Discount Price: $176
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hepatitis B vaccine at CHI St Lukes Health Memorial San Augustine is $394. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 511 Hospital St, San Augustine, TX.

Cash / Self-Pay

$176

Average discount available for prompt cash payment at this facility.

Insurance Median

$394

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
Cigna	$35 - $389	N/A
Blue Cross Blue Shield	$49 - $385	N/A
Aetna	$144 - $655	N/A
Humana	$144 - $1,833	N/A
Wellpoint	$149 - $577	N/A
United	$152 - $2,619	N/A
Scanhealth	$155 - $392	N/A
Md Save	$181 - $458	N/A
Angelina County	$394 - $1,001	N/A
Entrust	$413 - $1,047	N/A
Brookshire Brothers	$433 - $1,100	N/A
PHCS	$702 - $2,095	N/A
Multiplan	$722 - $1,833	N/A
Galaxy	$929 - $2,357	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 $176.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90744.

Insurance In-Network Protection Plan

Contact your insurance company to confirm CHI St Lukes Health Memorial San Augustine is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90744.
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.