CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $31
Cash Discount Price: $54
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Nemours Children's Hospital, Delaware is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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
Keystone First Hlth Plan	$11 - $24	N/A
Celtic Transplant	$14 - $54	N/A
Blue Cross Blue Shield	$17 - $48	N/A
Amerihealth Caritas Delaware	$17 - $31	N/A
Celtic Transplant for De First Health	$19	N/A
Delaware First Health	$19	N/A
Wellpoint Maryland	$20	N/A
UnitedHealthcare	$20 - $48	N/A
Kidz Partners	$20	N/A
Health Partners	$21	N/A
UPMC	$21 - $26	N/A
Fidelis	$22	N/A
Aetna	$23 - $31	N/A
Us Family Health Plan	$24	N/A
Priority Partners John Hopkins	$26	N/A
Six Degrees Health Transplant	$27	N/A
Cigna	$30 - $34	N/A
Great West-One Health Plan	$30 - $34	N/A
Ambetter / Centene	$31	N/A
Integra Administrative Group	$32	N/A
Geisinger Health Plan	$32	N/A
Six Degrees Health	$35	N/A
Star Healthcare Network	$35	N/A
National Transplant Network (Ntn)	$35	N/A
Life Trac Solid Organ and Bmt Transplant	$38	N/A
Carefirst Md Community Health Plan	$41	N/A
First Health Network	$51	N/A
Interlink Transplant Network	$51	N/A
Multiplan	$51	N/A
Private Healthcare Systems	$51	N/A
Preferred Healthcare	$51	N/A
Insurance Administrators of America	$51	N/A
Three Rivers Provider Network	$51	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 $54.
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 Nemours Children's Hospital, Delaware 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.