CMS Price Transparency Data

Hepatitis B vaccine

Facility: Intermountain Health Sanpete Valley Hospital

Billing Code: 90744 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90744
Insurance Median: $91
Cash Discount Price: $72
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Hepatitis B vaccine at Intermountain Health Sanpete Valley Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1100 South Medical Drive, Mount Pleasant, UT.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

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
Molina	$26 - $91	N/A
Health Plan of Nevada	$26 - $85	N/A
Selecthealth	$26 - $91	N/A
UnitedHealthcare	$29 - $91	N/A
American Health	$29 - $30	N/A
Blue Cross Blue Shield	$29 - $91	N/A
Humana	$29 - $91	N/A
Healthy U	$29 - $85	N/A
Health Partners of Nevada	$29 - $30	N/A
Aetna	$29 - $92	N/A
Triwest	$30 - $86	N/A
Injury Care of Nevada	$72	N/A
Wcf Insurance	$81	N/A
Corvel Corporation	$81	N/A
Byu Risk Management	$81	N/A
Corporation of the President	$81	N/A
Awh Connected	$91 - $92	N/A
Ifit	$91	N/A
Emi	$91	N/A
Hygeia Corporation	$91	N/A
Deseret Mutual	$91	N/A
Managed Care Admin	$91	N/A
Uofu	$91	N/A
Pehp	$91	N/A
Lw Miller	$91	N/A
Health Utah	$91	N/A
Campbell Scientific	$91	N/A
Wise Network	$91	N/A
Global Excel	$91	N/A
Franklin County	$91	N/A
Springtide	$91	N/A
Juniper Systems	$91	N/A
Tanner LLC	$91	N/A
Prodegi Corp Benefit	$91	N/A
Emi Health	$91	N/A
Medcare International	$91	N/A
Cigna	$91	N/A
Byu Athletics	$91	N/A
Utah Tech	$91	N/A
Motivhealth	$91	N/A

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 $72.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90744.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Intermountain Health Sanpete Valley Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90744.
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.