CMS Price Transparency Data

Pneumococcal vaccine

Facility: Kootenai Health

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $131
Cash Discount Price: $115
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Kootenai Health is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$115

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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
Molina Healthcare of Idaho	$40 - $137	N/A
Group Health/Kaiser	$88 - $480	N/A
Premera	$93 - $140	N/A
Wellpoint	$97 - $115	N/A
Magellan	$97 - $115	N/A
Mountain Health Co-Op	$118	N/A
Cigna	$125 - $127	N/A
Aetna	$127 - $140	N/A
First Choice Health (Ameriben)	$130 - $132	N/A
UnitedHealthcare	$130 - $140	N/A
Interwest Health	$130	N/A
Humana	$133	N/A
Regence Blue Shield of Idaho	$133 - $147	N/A
Pacificsource	$135 - $214	N/A
Blue Cross Blue Shield	$135 - $155	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 $115.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90732.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kootenai Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90732.
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.