CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Childrens Hospital of Wisconsin

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90371
Insurance Median: $256
Cash Discount Price: $166
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Childrens Hospital of Wisconsin is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 1.83x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$256

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: $166 (118%)

Insurance Median: $256 (183%)

Cash: $166 (118% of Medicare)

Ins. Median: $256 (183% 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.

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
Froedtert Health	$183 - $442	131%
Medical College of Wisconsin	$183 - $364	131%
Network Health Plan	$186 - $370	133%
UnitedHealthcare	$192 - $382	137%
Aspirus Health Plan	$196 - $390	140%
Common Ground Healthcare Cooperative	$196 - $442	140%
Trilogy Health Solutions	$196 - $442	140%
Wps Health Plan	$199 - $468	142%
Advocate Aurora Healthcare	$202 - $401	144%
Blue Cross Blue Shield	$204 - $494	145%
Centivo	$204 - $406	145%
Health Partners	$204 - $458	145%
Employer Health Care Alliance Cooperative	$206 - $408	147%
Dean Health Plan	$210 - $416	150%
Group Health Cooperative of Eau Claire	$210 - $416	150%
Oan LLC	$210 - $416	150%
Security Health Plan	$217 - $432	155%
Health Payment Systems	$222 - $440	158%
Praire States	$223 - $442	159%
Quartz Health Insurance	$223 - $442	159%
Sheboygan Employer's Health Network	$223 - $442	159%
Mayo Clinic Health Solutions	$228 - $453	163%
Aetna	$233 - $463	166%
Bellin Thedacare	$236 - $468	168%
Cigna	$236 - $468	168%
Group Health Cooperative of South Central Wisconsin	$236 - $468	168%
Prevea Health Network	$236 - $468	168%
Multiplan	$238 - $494	170%
Coventry Health Care	$249 - $494	178%

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 $166.
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 Childrens Hospital of Wisconsin 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.