CMS Price Transparency Data

Flu vaccine (high dose)

Facility: St Francis Hospital

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $23
Cash Discount Price: $71
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at St Francis Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$23

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

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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
Blue Cross Blue Shield	$14 - $27	N/A
Id County Other	$15	N/A
Eastpointe Lme	$15	N/A
Cmh Montcalm County	$15	N/A
Cmh Kalamazoo	$15	N/A
Priority Partners	$15	N/A
Bmc Healthnet	$15	N/A
Medi-Cal	$15	N/A
Vaya Health Lme	$15	N/A
Cmh Allegan County	$15	N/A
Indiana Breast Cervical Cancer	$15	N/A
Keystone First Chip	$15	N/A
Freedom First Healthcare	$15	N/A
Covid19 Hrsa Uninsured Testing and Treatment Fund	$15	N/A
Cmh Lenawee County	$15	N/A
Cmh North Country	$15	N/A
Harbor Health	$15	N/A
Cmh Wayne Cty/Com Liv Svcs	$15	N/A
La Care Health Plan	$15	N/A
Childrens Medical Services Title 19	$15	N/A
Trillium Community Ohp	$15	N/A
Kern Family Health Plan	$15	N/A
California Health and Wellness	$15	N/A
Cmh Jackson County/Lifeways	$15	N/A
Cmh Washtenaw County	$15	N/A
Robert F Sing Program	$15	N/A
Sandhills Center Lme	$15	N/A
Cmh West Mi County	$15	N/A
Ryan White Florida Mssrp	$15	N/A
Cmh Van Buren County	$15	N/A
Cigna	$15 - $23	N/A
Cmh Newaygo County	$15	N/A
Cardinal Innovations Lme	$15	N/A
Aetna	$15 - $50	N/A
Bccp	$15	N/A
Cencal Health Plan	$15	N/A
Dean Wi Badgercare	$15	N/A
Cmh Ausable Valley	$15	N/A
Inland Empire Health Plan	$15	N/A
Id County Cat Fund	$15	N/A
Cmh Livingston County	$15	N/A
Ambetter / Centene	$15 - $32	N/A
Cmh Oakland County	$15	N/A
Tenncare	$15	N/A
Rx Meridian Rx	$15	N/A
Medi-Cal Healthnet	$15	N/A
Oregon Screenwise	$15	N/A
Cmh Wayne County/Carelink	$15	N/A
Maryland Breast & Cervical Program	$15	N/A
Stephenson Cty Health	$15	N/A
Broward County Dept of Health	$15	N/A
Childrens Comm Health Plan	$15	N/A
Medicaid / KanCare	$15 - $23	N/A
Cmh Genesee County	$15	N/A
Washtenaw Health Plan	$15	N/A
Nebraska Total Care	$15	N/A
Iowa Total Care	$15	N/A
Care Oregon Ohp	$15	N/A
Dscc	$15	N/A
Sunshine State Health Plan	$15	N/A
Intercommunity Health Ohp	$15	N/A
Managed Health Services - Indiana	$15	N/A
Parkland Community Health Plan	$15	N/A
Cmh Ottawa County	$15	N/A
Paramount Advantage	$15	N/A
Humana	$15 - $23	N/A
St Joseph County Hlth Dpt	$15	N/A
Community Care Behavorial Health	$15	N/A
Care Connections of Northern Iowa	$15	N/A
Cenpatico	$15	N/A
Keystone First	$15	N/A
Id County Payette	$15	N/A
County Coroner	$15	N/A
Idaho Womens Health Check	$15	N/A
Nascentia Health Options	$15	N/A
Peach State Healthplan	$15	N/A
Ghc Scw Wi Badgercare	$15	N/A
Maryland Physicians Care	$15	N/A
Id County Ada	$15	N/A
Health Safety Net	$15	N/A
Amish Mennonite	$15	N/A
Connections Csp	$15	N/A
Partners Behavioral Lme	$15	N/A
Rx 340B Pass Along	$15	N/A
Lakeland Care Inc	$15	N/A
Pace of Southwest Michigan	$15 - $23	N/A
Medstar Dc Healthy Family	$15	N/A
Cmh Cass County	$15	N/A
Cmh Bay-Arenac County	$15	N/A
Mdwise	$15	N/A
Maryland Healthy Smiles - Scion Dental	$15	N/A
Texas Children's Health Plan	$15	N/A
Family Health Network	$15	N/A
Molina Centennial Care	$15	N/A
Jai Medical System	$15	N/A
Breast Grant-Connecticut	$15	N/A
Tufts Health Public Plans	$15	N/A
Nextlevel Health	$15	N/A
City of Philadelphia	$15	N/A
Bcccp-Michigan	$15	N/A
Medstar Md Health Choice	$15	N/A
Community Health Choice	$15	N/A
Albany County Correctional Facility	$15	N/A
Hennepin Health	$15	N/A
Cmh Monroe County	$15	N/A
Community Benefit Health	$15	N/A
New York Cancer Services Program	$15	N/A
Rx Assistance/Rx Manufacturer Assistance 0 Copay	$15	N/A
Mo Home State Health Plan	$15	N/A
Screening for Life	$15	N/A
UnitedHealthcare	$15 - $26	N/A
Prestige Health Choice	$15	N/A
Cmh Northern Lakes County	$15	N/A
Cmh Ionia County	$15	N/A
Cmh Barry County	$15	N/A
Cmh Muskegon County	$15	N/A
Cmh Misc	$15	N/A
Presbyterian Centennial Care	$15	N/A
Superior Health	$15	N/A
Delta Dental Nj	$15	N/A
Ascension St. Vincent Public Safety Medical	$15	N/A
Wi Womens Wellness	$15	N/A
Cmh Macomb	$15	N/A
Community Care Partners	$15	N/A
Cmh Central Mi County	$15	N/A
Healthy Blue Ne	$15	N/A
Delaware County Department of Health	$15	N/A
Fresno County Ccs	$15	N/A
County Funding Generic	$15	N/A
Cmh Detroit Wayne Integrated Health Network	$15	N/A
Rx Medi-Cal	$15	N/A
Cmh Kent County	$15	N/A
Cmh Clinton-Eaton-Ingham County	$15	N/A
Massachusetts Behavioral Health Partnership	$15	N/A
Chhuny	$15	N/A
Philadelphia County Funding	$15	N/A
Cmh Berrien County	$15	N/A
Dph Tb Program	$15	N/A
Wellsense Health Plan	$15	N/A
Idaho Dept Health and Wellfare	$15	N/A
Id County Canyon	$15	N/A
Delaware First Health	$18	N/A
Blue Shield - Wa (Regence)	$21	N/A
Kaiser Domestic	$21	N/A
Blue Shield - Ny Highmark Northeastern	$21	N/A
Blue Shield - Ny Highmark Western	$21	N/A
Health Choices	$21	N/A
Blue Shield - Id (Regence)	$21	N/A
Blue Distinction Transplant	$21	N/A
Wc Domestic	$21	N/A
Blue Benefit Administrators of Massachusetts	$21	N/A
Blue Shield - PA (Highmark)	$21	N/A
Bcn Domestic	$21	N/A
Pre-Employment	$21	N/A
Blue Shield - Ca	$21	N/A
Blue Care Network	$21	N/A
Champva	$22	N/A
Veterans Eval Services	$22	N/A
Tricare	$22	N/A
Triwest Health Alliance	$22	N/A
Us Family Health Plan	$22	N/A
Gpa Croell Redi Mix	$23	N/A
Care Resources Pace	$23	N/A
Secure Horizons Ma Pffs	$23	N/A
Serenity Pace	$23	N/A
Reliance Community Care Partners Care Resources Pace	$23	N/A
American Health Advantage of Idaho	$23	N/A
Evercare	$23	N/A
Care Improvement Plus	$23	N/A
Life St Marys Pace	$23	N/A
Eddy Seniorcare Pace	$23	N/A
Hope Select Pace	$23	N/A
Georgia Health Advantage	$23	N/A
Highmark Health Options Dual Plan	$23	N/A
Champion Health Plan McR Advantage	$23	N/A
Central Valley Medical Services Corp Pace	$23	N/A
Tribute Health Plans	$23	N/A
Rx Retiree Rx Care	$23	N/A
Martins Point Generations Advantage	$23	N/A
The Health Plan	$23	N/A
Eddy Senior Care-Pace	$23	N/A
Clear Spring Health	$23	N/A
Community Pace at Home	$23	N/A
Cca - Zing Health	$23	N/A
Meridian Complete	$23	N/A
Pace Cny	$23	N/A
Blue Shield - De (Highmark) Medciare Advantage	$23	N/A
Osu Prime Care Advantage	$23	N/A
Veterans Administration	$23	N/A
Peak Pace Solutions	$23	N/A
Gold Advantage	$23	N/A
Pruitthealth Premier	$23	N/A
Nascentia Health Plus	$23	N/A
Scan Health Plan McR IPA Meritage Oon	$23	N/A
Solis Health Plans	$23	N/A
Provider Partners Health Plan of Illinois	$23	N/A
Pace-Trinity Health	$23	N/A
Preferred Care Partners	$23	N/A
Lifecircles Pace	$23	N/A
Rx Allwin	$23	N/A
Mass General Brigham McR Adv	$23	N/A
Hudson Headwaters Pace	$23	N/A
Gateway Health Plan	$23	N/A
Horizon Nj Total Care	$23	N/A
Welbe Health	$23	N/A
Wellmed	$23	N/A
Texan Plus	$23	N/A
Genesys Pace of Genesee County	$23	N/A
Care Dimensions	$23	N/A
Health America Advantra	$23	N/A
Perennial Advantage	$23	N/A
Pace Southeast	$23	N/A
Siouxland Pace	$23	N/A
Innovative Integrated Health Community Plans	$23	N/A
Thome Pace	$23	N/A
Sunnyview-Pace Finance Dept	$23	N/A
American Health Plan	$23	N/A
Presbyterian Senior Plan	$23	N/A
Um Health Advantage	$23	N/A
Huron Valley Pace	$23	N/A
Blue Care Network Advantage	$23	N/A
Cca Senior Care Options	$23	N/A
Careplus Health Plans	$23	N/A
Pace Iowa Immanuel Pathways	$23	N/A
Rx Grane Grnmedd	$23	N/A
Medicare (plans)	$23 - $26	N/A
Lasso Healthcare Msa	$23	N/A
Provider Partners Health Plan of Indiana	$23	N/A
Ally Align Care Adv	$23	N/A
New Centry Health Careplus	$23	N/A
Everence	$23	N/A
Commonwealth Care Alliance	$23	N/A
Todays Options	$23	N/A
Align Senior Care	$23	N/A
Union Health Service	$23	N/A
Aurora Special Needs	$23	N/A
Clover Health	$23	N/A
Iowa Health Advantage	$23	N/A
Longevity Health Plan	$23	N/A
Johns Hopkins Advantage Md	$23	N/A
Longevity IPA of Michigan LLC Health Plan Isnp	$23	N/A
Mercyone Cedar Valley	$23	N/A
Medipak Advantage	$23	N/A
Michigan Complete Health	$23	N/A
Elementcare	$23	N/A
Mercy Life	$23	N/A
Wc Amtrust	$26	N/A
Wc Ct Healthcare Trust	$26	N/A
Wc Employee Mutual	$26	N/A
Wc Accident Fund	$26	N/A
Wc Qualcare	$26	N/A
Wc Zurich	$26	N/A
Wc Horizon	$26	N/A
Wc Amerisure	$26	N/A
Wc Guarantee Insurance	$26	N/A
Wc Walmart	$26	N/A
Wc Mdia	$26	N/A
Wc Fcci	$26	N/A
Wc Federated	$26	N/A
Wc Guard Insurance Company	$26	N/A
Wc Price Chopper	$26	N/A
Wc Rural Mutual	$26	N/A
Wc Mercy Workcare	$26	N/A
Wc Acuity	$26	N/A
Wc Hireright	$26	N/A
Wc Meadowbrook Claim	$26	N/A
Wc Tyson	$26	N/A
Wc Health Management	$26	N/A
Wc Novanet	$26	N/A
Wc Sedgwick	$26	N/A
Wc Taconic Farms	$26	N/A
Wc Aims	$26	N/A
Wc Society	$26	N/A
Wc Procura Management	$26	N/A
Wc Troy Ny	$26	N/A
Wc Mra	$26	N/A
Wc Zenith	$26	N/A
Wc Icw Group	$26	N/A
Wc West Bend Mutual/Argent	$26	N/A
Wc Quiktrip	$26	N/A
Wc Intermountain	$26	N/A
Wc California State Comp Ins	$26	N/A
Wc Encore Health Network	$26	N/A
Wc Unified Health Services	$26	N/A
Wc City of Albany	$26	N/A
Wc Cirma	$26	N/A
Wc Am Trust N America	$26	N/A
Wc Hartford	$26	N/A
Wc Praxis Health Network	$26	N/A
Wc Velocity	$26	N/A
Wc Risico	$26	N/A
Wc Advantage	$26	N/A
Wc Kemberton	$26	N/A
Wc First Agency/Occunet	$26	N/A
Wc Tristar	$26	N/A
Wc Taconic (Mro)	$26	N/A
Rx Restat	$26	N/A
Wc Fed Ex	$26	N/A
Wc General Motors	$26	N/A
Jag Source	$26	N/A
Wc Federal Black Lung	$26	N/A
Wc Cna	$26	N/A
Wc Capitol Area Health Consortium	$26	N/A
Wc Chartis	$26	N/A
Wc Berkley Admin	$26	N/A
Wc Ohio Bureau	$26	N/A
Wc Notre Dame	$26	N/A
Wc United Heartland	$26	N/A
Rx Saif Opdp Wc	$26	N/A
Wc Ccmsi	$26	N/A
Wc Sheakley Unicomp	$26	N/A
Wc Gallagher Bassett	$26	N/A
Healthsmart Workers Comp	$26	N/A
Wc Us Dept of Labor	$26	N/A
Wc Liberty Mutual	$26	N/A
Wc Johns Eastern	$26	N/A
Rx Heatlhcomp	$26	N/A
New York State Insurance Fund	$26	N/A
Wc Medical Administrators	$26	N/A
Wc Evolutions	$26	N/A
Wc Memic	$26	N/A
Wc Massachusetts	$26	N/A
Wc Aegis	$26	N/A
Wc Michigan Millers Mutual	$26	N/A
Wc Comp One Admin C/O Manageability	$26	N/A
Wc California State Ins Fund	$26	N/A
Wc Hastings	$26	N/A
Wc Broward County	$26	N/A
Wc Occ Health Allen	$26	N/A
Wc Peerless	$26	N/A
Wc Nca Comp	$26	N/A
Wc Chubb	$26	N/A
Rx Worker's Comp	$26	N/A
Wc Benetech	$26	N/A
Wc New York Special Funds	$26	N/A
Wc North American Rishces	$26	N/A
Wc Secura	$26	N/A
Wc Erie	$26	N/A
Njm Insurance Group	$26	N/A
Wc New York	$26	N/A
Wc Winnebago Industries	$26	N/A
Wc City of Sioux City	$26	N/A
Wc Triad Group	$26	N/A
Wc Great West Casualty	$26	N/A
Wc Rev Claims	$26	N/A
Genex Wc	$26	N/A
Wc Srs	$26	N/A
Wc Generic	$26	N/A
Geha	$26	N/A
Wc Mitchell Frankenmuth	$26	N/A
Wc Paradigm	$26	N/A
Wc Northeast Health	$26	N/A
Wc Alaska National Ins	$26	N/A
Wc Genex Care for Ohio	$26	N/A
Wc Finley Occupational Health	$26	N/A
Wc Ace	$26	N/A
Wc Align Network	$26	N/A
Wc American Claims Mgmt	$26	N/A
Wc West Bend	$26	N/A
Wc Hab	$26	N/A
Wc Ford Motor	$26	N/A
Wc Heritage Summit	$26	N/A
Wc Saif Oregon	$26	N/A
Wc One Call Medical	$26	N/A
Wc Idaho State Ins Fund	$26	N/A
Wc Michigan	$26	N/A
Wc Fresno Unified Emp	$26	N/A
Wc Pma	$26	N/A
Andrie Inc	$26	N/A
Wc Nationwide	$26	N/A
Wc Bunch & Associates	$26	N/A
Wc Claims Mgmt Inc	$26	N/A
Wc Travelers	$26	N/A
Wc Intercare Insurance	$26	N/A
Wc Compone Admin	$26	N/A
Wc O'Hara Corp	$26	N/A
Wc Donegal Insurance Group	$26	N/A
Wc Allied	$26	N/A
Wc Sentry	$26	N/A
Wc Asu Risk Mgt	$26	N/A
Wc Smile Lodge	$26	N/A
Wc Yankee Trails	$26	N/A
Wc Acs Federal Employees	$26	N/A
Wc Esis	$26	N/A
Wc Meijers	$26	N/A
East Greenbush Central School District	$26	N/A
Wc Key Ins & Benefit Solutions	$26	N/A
Wc Emc Insurance Company	$26	N/A
Wc Aig	$26	N/A
Wc Reny Company	$26	N/A
Wc Broadspire	$26	N/A
Wc York Risk	$26	N/A
Wc Enablecomp	$26	N/A
Wc Mac Risk Management	$26	N/A
Coventry	$50	N/A
Meritain	$50	N/A
Multiplan	$60	N/A
Pai	$60	N/A
Asrm - Reliance Standard Life Insurance	$60	N/A
Family Life Insurance Company	$60	N/A
PHCS	$60	N/A
Fallon Health	$60	N/A
Trinity Health Share	$60	N/A
Pan-American Life	$60	N/A
Lifetime Benefit Solutions	$60	N/A
Paramount HMO	$60	N/A
Christian Care Ministry	$60	N/A
Ghc Scw	$60	N/A
Medi Share	$60	N/A
Allied National Global Care	$60	N/A
International Benefit Administrators	$60	N/A
Dean Health	$60	N/A
Manhattan Life	$60	N/A
Devon Health Services	$60	N/A
Vitalcore	$64	N/A
Prime Health Services	$67	N/A
Wc Corvel	$67	N/A
Three Rivers Provider Network	$67	N/A
Galaxy Health Network	$67	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 $71.
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 St Francis 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.