CMS Price Transparency Data

MMR vaccine (measles, mumps, rubella)

Facility: CHI St Lukes Health Memorial San Augustine

Billing Code: 90707 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90707
  • Insurance Median: $534
  • Cash Discount Price: $179
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a MMR vaccine (measles, mumps, rubella) at CHI St Lukes Health Memorial San Augustine is $534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $179. 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
$179

Average discount available for prompt cash payment at this facility.

Insurance Median
$534

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.

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
Cigna $117 - $187 N/A
Blue Cross Blue Shield $150 - $182 N/A
United $189 - $1,334 N/A
Aetna $263 - $334 N/A
Angelina County $421 - $534 N/A
Entrust $421 - $534 N/A
PHCS $716 - $1,067 N/A
Humana $737 - $934 N/A
Multiplan $737 - $934 N/A
Galaxy $947 - $1,201 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 511 Hospital St, San Augustine, TX 75972
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Rural Emergency Hospital