CMS Price Transparency Data

DTaP vaccine (diphtheria, tetanus, pertussis)

Facility: Lewisgale Hospital Alleghany

Billing Code: 90700 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90700
Insurance Median: $107
Cash Discount Price: $149
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a DTaP vaccine (diphtheria, tetanus, pertussis) at Lewisgale Hospital Alleghany is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in One Arh Lane - Po Box 7, Low Moor, VA.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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
Triatlantic	$27	N/A
Health Net	$29	N/A
Humana	$31	N/A
Virginia Health Network	$52 - $106	N/A
United	$57 - $98	N/A
Aetna	$81	N/A
Greenvbrier Sporting Club	$90	N/A
Cigna	$93	N/A
Corvel	$108	N/A
Csx Hotels	$120	N/A
Occunet Workers Comp	$120	N/A
Health Payors Organization	$127	N/A
4Most	$135	N/A
Alleghany Highland Community	$135	N/A
American Postal Workers Union	$135	N/A
C&O Employees Hospital Assn	$135	N/A
Community Care Network	$135	N/A
Multiplan	$135	N/A
One Health Plan	$135	N/A
United Behavioral Health	$149	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 $149.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lewisgale Hospital Alleghany is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90700.
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.