CMS Price Transparency Data

Rabies immune globulin

Facility: Mountain View Hospital

Billing Code: 90375 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90375
Insurance Median: $501
Cash Discount Price: $17,463
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Rabies immune globulin at Mountain View Hospital is $501. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,463. Compared to the federal Medicare reimbursement reference rate of $275.18, this hospital’s rate is 1.82x the Medicare baseline. Located in 1000 East 100 North, Payson, UT.

Cash / Self-Pay

$17,463

Average discount available for prompt cash payment at this facility.

Insurance Median

$501

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$275.18

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $275.18 (100%)

Cash / Self-Pay: $17,463 (6346%)

Insurance Median: $501 (182%)

Cash: $17,463 (6346% of Medicare)

Ins. Median: $501 (182% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $275.18 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.

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
Regence Triwest	$286	104%
Cigna	$328 - $424	119%
Regence	$450 - $732	164%

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 $17,463.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90375.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mountain View Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90375.
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.