CMS Price Transparency Data

Pneumococcal vaccine

Facility: Childrens Hospital of the Kings Daughters Inc

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $360
Cash Discount Price: $428
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Childrens Hospital of the Kings Daughters Inc is $360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $428. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 601 Children's Lane, Norfolk, VA.

Cash / Self-Pay

$428

Average discount available for prompt cash payment at this facility.

Insurance Median

$360

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
Carolina Complete Health	$5 - $118	N/A
Wellcare	$5 - $119	N/A
Amerihealth Caritas	$5 - $115	N/A
Healthy Blue	$5 - $115	N/A
Aetna	$11 - $412	N/A
Sentara Community Plan	$11 - $45	N/A
UnitedHealthcare	$11 - $412	N/A
Blue Cross Blue Shield	$11 - $267	N/A
Humana	$14 - $47	N/A
Johns Hopkins Healthcare	$20 - $477	N/A
Sentara Health Plans	$220 - $232	N/A
Cigna	$316 - $333	N/A
Virginia Health Network	$333 - $401	N/A
Medcost	$404 - $462	N/A
First Health	$428 - $452	N/A
Vhn	$438 - $477	N/A
Multiplan	$438 - $462	N/A
PHCS	$438 - $477	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 $428.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90732.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Childrens Hospital of the Kings Daughters Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90732.
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.