CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Mountain West Medical Center

Billing Code: 90371 (HCPCS)

The BaseRate · fair price high confidence

A fair price for this

$188

about 1.3× the $140 Medicare rate · typically $135–$261

modeled estimate · not a bill or quote

What this hospital charges insurers

$134

Below the fair price — a good deal

about $54 under the fair price · 1.0× Medicare

Medicare pays $140 Fair price $188 This hospital $134 Cash price $272 Hospital's list price $453

How we calculate the fair BaseRate →

How this hospital compares to other UT hospitals

Highest price of the 9 UT hospitals we have prices for — worth calling around.

Cheapest $128 Priciest $134

Black dot = this hospital, among the 9 UT hospitals with a price for this procedure. Full list below.

A fair price for a Hepatitis B immune globulin is about $188 (about 1.3× the $140 Medicare rate). Mountain West Medical Center charges insurers about $134, or about $272 in cash — below the fair price — a good deal. Located in Tooele, UT.

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	$217 - $875	155%
Blue Cross Blue Shieldmajor	$118 - $134	84%
Aetnamajor	$211 - $853	150%
Cignamajor	$200 - $806	143%
Humanamajor	$239 - $966	170%
SelectHealth	$134 - $853	96%
+ 5 smaller / regional plans	$183 - $966

Government programs also on file: Medicare.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 272), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the HCPCS code on your bill matches exactly: 90371.

Insurance Before you use insurance

Call your insurance company to confirm Mountain West Medical Center is in-network.
Ask your insurer whether prior approval is required for HCPCS code 90371.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mountain West Medical Center

Compare: Hepatitis B immune globulin at other UT hospitals

Insurance negotiated median for the same procedure, sorted lowest first.