CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Holy Family Memorial

Billing Code: 90371 (HCPCS)

The BaseRate · fair price high confidence
A fair price for this
$135
about 1.0× the $140 Medicare rate · typically $134–$343
modeled estimate · not a bill or quote
What this hospital charges insurers
$136
About the fair price
about $1 over the fair price · 1.0× Medicare
Medicare pays $140 Fair price $135 This hospital $136

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

On the higher side — 6 of 8 other WI hospitals charge less.

Cheapest $123 Priciest $137

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Hepatitis B immune globulin is about $135 (about 1.0× the $140 Medicare rate). Holy Family Memorial charges insurers about $136 — about the fair price. Located in Manitowoc, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $134 - $155 96%
Blue Cross Blue Shieldmajor $134 - $176 96%
Humanamajor $134 96%
Dean Health Plan $193 138%
HealthPartners $134 96%
Molina $134 - $145 96%
Security Health Plan $134 96%
+ 4 smaller / regional plans $134 - $155

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Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals