CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Holy Cross Hospital-Davis

Billing Code: 90371 (HCPCS)

The BaseRate · fair price high confidence

A fair price for this

$219

about 1.6× the $140 Medicare rate · typically $135–$293

modeled estimate · not a bill or quote

What this hospital charges insurers

$204

About the fair price

about $15 under the fair price · 1.5× Medicare

Medicare pays $140 Fair price $219 This hospital $204 Cash price $401 Hospital's list price $1,001

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 $204

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 $219 (about 1.6× the $140 Medicare rate). Holy Cross Hospital-Davis charges insurers about $204, or about $401 in cash — about the fair price. Located in Layton, 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	$307 - $4,801	219%
Blue Cross Blue Shieldmajor	$183 - $2,881	131%
Aetnamajor	$234 - $4,057	167%
Cignamajor	$190 - $3,841	136%
Humanamajor	$132	94%
Molina	$228 - $2,062	163%
SelectHealth	$261 - $2,360	186%
+ 8 smaller / regional plans	$134 - $4,177

Government programs also on file: Medicare, Medicaid.

Excludes 1 rental-network / third-party entry (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 401), 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 Holy Cross Hospital-Davis 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 Holy Cross Hospital-Davis

Compare: Hepatitis B immune globulin at other UT hospitals

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