CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Stonesprings Hospital Center

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90371
Insurance Median: $737
Cash Discount Price: $1,228
vs. Medicare Baseline: 5.26x Medicare

The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Stonesprings Hospital Center is $737. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,228. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 5.26x the Medicare baseline. Located in 24440 Stone Springs Boulevard, Dulles, VA.

Cash / Self-Pay

$1,228

Average discount available for prompt cash payment at this facility.

Insurance Median

$737

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$140.21

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $140.21 (100%)

Cash / Self-Pay: $1,228 (876%)

Insurance Median: $737 (526%)

Cash: $1,228 (876% of Medicare)

Ins. Median: $737 (526% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $140.21 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 526% of the Medicare baseline (a markup of 426%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$107	76%
Johns Hopkins	$143	102%
Cigna	$153 - $246	109%
Carefirst	$203	145%
United	$311 - $2,417	222%
Greenvbrier Sporting Club	$599 - $3,223	427%
Virginia Health Network	$709 - $3,814	506%
Corvel	$719 - $3,868	513%
Three Rivers Provider Network	$848 - $4,566	605%

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 $1,228.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90371.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Stonesprings Hospital Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90371.
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.