CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Johnson Memorial Hospital

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $75
Cash Discount Price: $102
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Johnson Memorial Hospital is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$75

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
Connecticare	$9 - $16	N/A
Connecticut Dept of Correction	$22	N/A
Medicare (plans)	$25 - $41	N/A
Fallon Health	$25	N/A
Cigna	$26 - $80	N/A
Health Partners	$26	N/A
Magnacare	$26	N/A
Allegiance	$26	N/A
Aetna	$39 - $80	N/A
Blue Cross Blue Shield	$39 - $75	N/A
UnitedHealthcare	$39 - $102	N/A
Cca Senior Care Options	$40	N/A
Health New England	$67	N/A
Blue Benefit Administrators of Massachusetts	$75	N/A
Wellpoint	$75	N/A
Blue Shield - Ny Highmark Northeastern	$75	N/A
Unicare	$75	N/A
Pre-Employment	$75	N/A
Blue Distinction Transplant	$75	N/A
Blue Shield - Ca	$75	N/A
Blue Shield - Wa (Regence)	$75	N/A
Blue Shield - Ny Highmark Western	$75	N/A
Blue Shield - PA (Highmark)	$75	N/A
Kaiser Domestic	$75	N/A
Blue Care Network	$75	N/A
Blue Shield - Id (Regence)	$75	N/A
Wc Domestic	$75	N/A
Health Choices	$75	N/A
Bcn Domestic	$75	N/A
Nippon Life Ins	$80	N/A
Gravie Admin Services	$80	N/A
Meritain	$80	N/A
Luminare Health	$80	N/A
1199 National Benefit Fund	$80	N/A
Hap	$80	N/A
Webtpa	$80	N/A
Allied Benefit Systems	$80	N/A
Harvard Pilgrim Healthcare	$82	N/A
Prime Health Services	$82	N/A
Geha	$82	N/A
Diversified Administrators	$84	N/A
Innovative Health Plan II	$84	N/A
Claimdoc	$84	N/A
Manhattan Life	$85	N/A
Mvp	$85	N/A
Family Life Insurance Company	$85	N/A
Trinity Health Share	$85	N/A
Asrm - Reliance Standard Life Insurance	$85	N/A
Christian Care Ministry	$85	N/A
Lifetime Benefit Solutions	$85	N/A
Pan-American Life	$85	N/A
Allied National Global Care	$85	N/A
PHCS	$85	N/A
Medi Share	$85	N/A
Paramount HMO	$85	N/A
Multiplan	$85	N/A
International Benefit Administrators	$85	N/A
Pai	$85	N/A
Dean Health	$85	N/A
Ghc Scw	$85	N/A
Health Smart	$87	N/A
Centivo	$93	N/A
United Behavioral Health Eap	$102	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 $102.
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 Johnson Memorial Hospital 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.