CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Holy Cross Hospital-Davis

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90371
  • Insurance Median: $778
  • Cash Discount Price: $401
  • vs. Medicare Baseline: 5.55x Medicare
The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Holy Cross Hospital-Davis is $778. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $401. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 5.55x the Medicare baseline. Located in 1600 West Antelope Drive, Layton, UT.
Cash / Self-Pay
$401

Average discount available for prompt cash payment at this facility.

Insurance Median
$778

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$140.21

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $140.21 (100%)
Cash / Self-Pay: $401 (286%)
Insurance Median: $778 (555%)
Cash: $401 (286% of Medicare)
Ins. Median: $778 (555% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $140.21 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 555% of the Medicare baseline (a markup of 455%). 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
Humana $132 94%
Medicare (plans) $132 94%
Uuhp $134 - $2,602 96%
Medicaid / KanCare $134 96%
Employer Direct Healthcare $165 118%
Motivhealth $174 124%
Blue Cross Blue Shield $183 - $2,881 131%
Centura Employee Plan $186 - $1,680 133%
Cigna $190 - $3,841 136%
Pehp $227 - $2,785 162%
Molina $228 - $2,062 163%
Aetna $234 - $4,057 167%
Select Health $261 - $2,360 186%
Wise $276 - $2,545 197%
UnitedHealthcare $307 - $4,801 219%
Multiplan $313 - $4,369 223%
Deseret Mutual Benefit Administrators $326 - $2,948 233%
Emi Health $462 - $4,177 330%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 West Antelope Drive, Layton, UT 84041
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals