CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: CHI St Lukes Health Memorial San Augustine

Billing Code: 90716 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$264
modeled fair price · typically $94–$685
modeled estimate · not a bill or quote
Fair price $264 Cash price $419 Hospital's list price $2,792

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $470 - $2,974 —
Blue Cross Blue Shieldmajor $340 - $411 —
Aetnamajor $653 - $744 —
Cignamajor $232 - $416 —
Humanamajor $1,827 - $2,082 —
+ 2 smaller / regional plans $1,044 - $1,190
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

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