CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Connecticut Childrens Medical Center

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90371
Insurance Median: $503
Cash Discount Price: $779
vs. Medicare Baseline: 3.59x Medicare

The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Connecticut Childrens Medical Center is $503. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $779. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 3.59x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$779

Average discount available for prompt cash payment at this facility.

Insurance Median

$503

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: $779 (556%)

Insurance Median: $503 (359%)

Cash: $779 (556% of Medicare)

Ins. Median: $503 (359% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 359% of the Medicare baseline (a markup of 259%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Golden Rule [100106]	$168 - $1,007	120%
Oxford [100103]	$168 - $1,007	120%
UnitedHealthcare	$168 - $1,632	120%
Harvard Pilgrim [1001134]	$168 - $1,470	120%
Cigna	$200 - $1,741	143%
Tufts Health Plan [100114]	$200 - $1,741	143%
Health Partners [110229]	$200 - $1,741	143%
Great West Healthcare [100107]	$200 - $1,741	143%
Mvp Health Plan [100144]	$200 - $1,741	143%
Wellpoint [100150]	$217 - $1,522	155%
Blue Cross Blue Shield	$217 - $1,522	155%
Unicare [100148]	$217 - $1,522	155%
Medicaid / KanCare	$226 - $1,632	161%
Emblem Health Commercial [1001108]	$226 - $1,632	161%
Connecticare [100105]	$226 - $1,632	161%
Aetna	$358 - $1,694	255%
Government Employees Hospital Assoc [100115]	$398 - $1,694	284%
1199 National Benefit Fund [100134]	$398 - $1,694	284%
Humana	$398 - $1,694	284%
Nippon Life Ins Co of America [100112]	$398 - $1,694	284%
Meritain Health [100149]	$398 - $1,694	284%
Yale Health Plan [100162]	$398 - $1,694	284%
Multiplan [1001126]	$424 - $1,712	302%
Cdphp/Comm [100199]	$494 - $1,712	352%
Generic Multiplan [1001130]	$494 - $1,712	352%
Ultrabenefits/Comm [100181]	$494 - $1,712	352%

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 $779.
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 Connecticut Childrens Medical Center 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.