CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Uva Health Culpeper Medical Center

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $268
Cash Discount Price: $206
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Uva Health Culpeper Medical Center is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$206

Average discount available for prompt cash payment at this facility.

Insurance Median

$268

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 (%)

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$172 - $338	N/A
Beacon Health Options [40012]	$181 - $192	N/A
Champva [50002]	$185	N/A
Tricare	$185	N/A
Commercial Contracted Hb Only [40056]	$190 - $202	N/A
Commercial Generic [40000]	$190 - $269	N/A
Carefirst [30007]	$192 - $204	N/A
UnitedHealthcare	$202 - $238	N/A
Sentara [40021]	$206 - $299	N/A
Sentara Behavioral Health [40052]	$210 - $299	N/A
Commercial Contracted Tpa [40055]	$217 - $269	N/A
Geha [40009]	$224 - $238	N/A
Cigna	$242 - $479	N/A
Umwa [40037]	$253 - $269	N/A
Healthsmart [40013]	$272 - $288	N/A
Multiplan Generic [40035]	$275 - $327	N/A
Vhn Generic [40040]	$275 - $327	N/A
First Health Generic [40033]	$297 - $315	N/A
Gateway Health Alliance [40034]	$308 - $327	N/A
Onenet Workers Comp Generic [60010]	$317 - $337	N/A
Kaiser Permenente [40014]	$326 - $346	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 $206.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90716.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Uva Health Culpeper Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90716.
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.