CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $54
Cash Discount Price: $37
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Childrens Hospital of Wisconsin Fox Valley is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 130 Second St, Neenah, WI.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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
Multiplan	$10 - $66	N/A
UnitedHealthcare	$21 - $51	N/A
Chorus Community Health Plan	$22	N/A
Molina Healthcare of Wisconsin	$22	N/A
Blue Cross Blue Shield	$23 - $66	N/A
Icare	$23	N/A
Managed Health Services	$23	N/A
My Choice Wisconsin	$23	N/A
Employer Health Care Alliance Cooperative	$26 - $54	N/A
Aetna	$31 - $61	N/A
Froedtert Health	$42 - $60	N/A
Medical College of Wisconsin	$42 - $49	N/A
Network Health Plan	$43 - $49	N/A
Aspirus Health Plan	$45 - $52	N/A
Common Ground Healthcare Cooperative	$45 - $59	N/A
Trilogy Health Solutions	$45 - $59	N/A
Wps Health Plan	$45 - $62	N/A
Advocate Aurora Healthcare	$46 - $53	N/A
Centivo	$47 - $54	N/A
Health Partners	$47 - $61	N/A
Dean Health Plan	$48 - $56	N/A
Group Health Cooperative of Eau Claire	$48 - $56	N/A
Oan LLC	$48 - $56	N/A
Security Health Plan	$50 - $58	N/A
Health Payment Systems	$51 - $59	N/A
Praire States	$51 - $59	N/A
Quartz Health Insurance	$51 - $59	N/A
Sheboygan Employer's Health Network	$51 - $59	N/A
America's PPO	$52 - $60	N/A
Bellin Thedacare	$54 - $62	N/A
Cigna	$54 - $62	N/A
Group Health Cooperative of South Central Wisconsin	$54 - $62	N/A
Healthsmart	$54 - $62	N/A
Prevea Health Network	$54 - $62	N/A
Coventry Health Care	$57 - $66	N/A
Quartz Health Solutions	$57	N/A
Healthsmart Payers Organization	$60	N/A
Health Payers Organization	$64	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 $37.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90656.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Childrens Hospital of Wisconsin Fox Valley is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90656.
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.