CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Mercyone Oelwein Medical Center

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $183
Cash Discount Price: $149
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Mercyone Oelwein Medical Center is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$183

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 (%)

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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
Medicare (plans)	$88 - $98	N/A
Iowa Total Care	$89	N/A
Medicaid / KanCare	$90	N/A
Blue Cross Blue Shield	$93 - $183	N/A
UnitedHealthcare	$100 - $198	N/A
Aetna	$108 - $210	N/A
Amish Hospital Aid	$125	N/A
Centivo	$141	N/A
Ambetter / Centene	$158	N/A
Health Choices	$169	N/A
Medical Associates	$169	N/A
Blue Shield - Ny Highmark Northeastern	$183	N/A
Blue Shield - Id (Regence)	$183	N/A
Blue Care Network	$183	N/A
Blue Distinction Transplant	$183	N/A
Pre-Employment	$183	N/A
Blue Shield - Ca	$183	N/A
Blue Shield - Wa (Regence)	$183	N/A
Blue Shield - Ny Highmark Western	$183	N/A
Kaiser Domestic	$183	N/A
Bcn Domestic	$183	N/A
Blue Shield - PA (Highmark)	$183	N/A
Blue Benefit Administrators of Massachusetts	$183	N/A
Wc Domestic	$183	N/A
Nova	$189	N/A
Claimdoc	$189	N/A
Geha	$198	N/A
First Health	$210	N/A
Coventry	$210	N/A
Allied Benefit Systems	$210	N/A
Trustmark Small Business Benefits	$210	N/A
Asr Health Benefits	$210	N/A
Luminare Health	$210	N/A
Lucent Health	$210	N/A
Christian Brother Services	$210	N/A
Webtpa	$210	N/A
Medical Mutual	$210	N/A
Meritain	$210	N/A
1199 National Benefit Fund	$210	N/A
Health Partners	$220	N/A
Multiplan	$222	N/A
Medica	$224	N/A
Auxiant	$224	N/A
Midlands Choice	$224	N/A
Midlands	$224	N/A
Cigna	$224	N/A
Iowa Dept of Public Health	$229	N/A
Crime Victim Assistance	$229	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 $149.
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 Mercyone Oelwein Medical Center 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.