CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Lewisgale Medical Center

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $51
Cash Discount Price: $71
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Lewisgale Medical Center is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1900 Electric Road, Salem, VA.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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
Cigna	$12 - $31	N/A
Triatlantic	$19	N/A
Health Net	$20	N/A
Humana	$22	N/A
Virginia Health Network	$25 - $50	N/A
United	$26 - $70	N/A
Naphcare	$36	N/A
Greenvbrier Sporting Club	$43	N/A
Richfield Nursing Center	$50	N/A
Graham-White Manufacturing	$50	N/A
Corvel	$51	N/A
Community Care Network	$53	N/A
Richfield Retirement Community	$53	N/A
Occunet Workers Comp	$57	N/A
Csx Hotels	$57	N/A
One Health Plan	$57	N/A
Patients Choice	$62	N/A
C&O Employees Hospital Assn	$64	N/A
4Most	$64	N/A
Star Transportation	$64	N/A
Multiplan	$64	N/A
Alleghany Highland Community	$64	N/A
American Postal Workers Union	$64	N/A
PHCS	$64	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 $71.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90656.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lewisgale Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90656.
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.