CMS Price Transparency Data

Rabies immune globulin

Facility: Mountain West Medical Center

Billing Code: 90375 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90375
  • Insurance Median: $622
  • Cash Discount Price: $506
  • vs. Medicare Baseline: 2.26x Medicare
The contracted insurance negotiated median rate for a Rabies immune globulin at Mountain West Medical Center is $622. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $506. Compared to the federal Medicare reimbursement reference rate of $275.18, this hospital’s rate is 2.26x the Medicare baseline. Located in 2055 North Main Street, Tooele, UT.
Cash / Self-Pay
$506

Average discount available for prompt cash payment at this facility.

Insurance Median
$622

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: $506 (184%)
Insurance Median: $622 (226%)
Cash: $506 (184% of Medicare)
Ins. Median: $622 (226% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 226% of the Medicare baseline (a markup of 126%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $280 - $302 102%
Select Health McR Adv $280 102%
Medicare (plans) $350 127%
U of Ut-All Plans $524 - $572 190%
Wise/Motivhealth-All Plans $524 - $572 190%
Cigna $572 - $624 208%
Dmba-All Plans $581 - $633 211%
Aetna $605 - $660 220%
Pehp-All Plans $605 - $660 220%
Select Health-All Other Plans $605 - $660 220%
UnitedHealthcare $621 - $677 226%
Multiplan Primary Network-All Other Plans $637 - $695 231%
Emi-All Plans $686 - $748 249%
Humana $686 - $748 249%
Multiplan Complimentary Network $742 - $809 270%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2055 North Main Street, Tooele, UT 84074
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals