CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $223
Cash Discount Price: $153
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Childrens Hospital of Wisconsin Fox Valley is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $153. 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

$153

Average discount available for prompt cash payment at this facility.

Insurance Median

$223

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 (%)

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
UnitedHealthcare	$15 - $495	N/A
Blue Cross Blue Shield	$16 - $135	N/A
Chorus Community Health Plan	$16	N/A
Icare	$16	N/A
Managed Health Services	$16	N/A
Molina Healthcare of Wisconsin	$16	N/A
My Choice Wisconsin	$16	N/A
Multiplan	$78 - $254	N/A
Employer Health Care Alliance Cooperative	$127	N/A
Network Health Plan	$192	N/A
Medical College of Wisconsin	$195	N/A
Wps Health Plan	$195	N/A
Aspirus Health Plan	$201	N/A
Common Ground Healthcare Cooperative	$201	N/A
Centivo	$204	N/A
Advocate Aurora Healthcare	$209	N/A
Health Partners	$218 - $246	N/A
Dean Health Plan	$223	N/A
Froedtert Health	$223 - $251	N/A
Oan LLC	$223	N/A
Trilogy Health Solutions	$223	N/A
Security Health Plan	$232	N/A
Health Payment Systems	$236	N/A
Aetna	$237 - $259	N/A
Quartz Health Solutions	$237	N/A
Sheboygan Employer's Health Network	$237	N/A
America's PPO	$243	N/A
Cigna	$251	N/A
Group Health Cooperative of South Central Wisconsin	$251	N/A
Healthsmart Payers Organization	$251	N/A
Coventry Health Care	$265	N/A
Health Payers Organization	$265	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 $153.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90716.

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 90716.
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.