CMS Price Transparency Data

Pneumococcal vaccine

Facility: CHI St Lukes Health Memorial San Augustine

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $297
Cash Discount Price: $251
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at CHI St Lukes Health Memorial San Augustine is $297. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $251. 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

$251

Average discount available for prompt cash payment at this facility.

Insurance Median

$297

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
Aetna	$5 - $734	N/A
Cigna	$5 - $436	N/A
Humana	$5 - $2,056	N/A
Blue Cross Blue Shield	$6 - $432	N/A
Scanhealth	$6 - $440	N/A
United	$6 - $2,937	N/A
Wellpoint	$6 - $648	N/A
Md Save	$7 - $514	N/A
Angelina County	$15 - $1,122	N/A
Brookshire Brothers	$16 - $1,233	N/A
Entrust	$16 - $1,175	N/A
PHCS	$26 - $2,349	N/A
Multiplan	$27 - $2,056	N/A
Galaxy	$35 - $2,643	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 $251.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90732.

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 90732.
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.