CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Cody Regional Health

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $133
Cash Discount Price: $126
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Cody Regional Health is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 707 Sheridan Avenue, Cody, WY.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$133

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
Tricare	$68	N/A
Cigna	$117	N/A
Christian Hlthcare - All Plans	$118	N/A
Blue Cross Blue Shield	$127 - $141	N/A
First Choice Health - All Plans	$133	N/A
Medica Comm - All Other Plans	$133	N/A
Mountain Health - All Plans	$133	N/A
Pacific Source - All Plans	$133	N/A
Rocky Mtn Admin - All Plans	$133	N/A
Interwest Health PPO - All Plans	$136	N/A
First Health Ntwrk-All Plans	$138	N/A
Humana	$138	N/A
UnitedHealthcare	$138	N/A
Three Rivers - All Plans	$141	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 $126.
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 Cody Regional Health 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.