CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $317
Cash Discount Price: $376
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Ann & Robert H Lurie Childrens Hospital of Chicago is $317. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $376. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.

Cash / Self-Pay

$376

Average discount available for prompt cash payment at this facility.

Insurance Median

$317

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)	$57 - $2,656	N/A
Mercycare Health	$124 - $274	N/A
Cigna	$140 - $526	N/A
Blue Cross Blue Shield	$145 - $593	N/A
Aetna	$167 - $580	N/A
La Rabida Childrens Hospital	$167 - $370	N/A
Beacon Health Options	$167 - $370	N/A
UnitedHealthcare	$192 - $206	N/A
Centegra	$200 - $444	N/A
Independent Physicians at Mercy	$200 - $444	N/A
Imagine Health	$234 - $519	N/A
Methodist First Choice	$234 - $519	N/A
Health Plus	$234 - $519	N/A
St. Francis	$234 - $519	N/A
Northwest Community Healthcare	$234 - $519	N/A
Ui Health	$234 - $519	N/A
Advanced Physicians Association IPA	$234 - $519	N/A
Presence Health Partners	$234 - $519	N/A
West Suburban Health Providers	$234 - $519	N/A
Swedish Covenant Physician Partners	$251 - $556	N/A
Shriners Hospital	$251 - $556	N/A
American Psych Systems	$267 - $593	N/A
Macneal Health	$267 - $593	N/A
Magellan	$267 - $900	N/A
Health Alliance	$267 - $593	N/A
Healthlink Inc.	$276 - $611	N/A
Hfn Inc	$284 - $667	N/A
Humana	$284 - $630	N/A
Principal Healthcare	$284 - $630	N/A
St. Elizabeth	$284 - $630	N/A
Cofinity	$284 - $630	N/A
Preferred Health Network	$294 - $652	N/A
Healthstar	$294 - $652	N/A
Sagamore Health Network	$294 - $652	N/A
First Health	$294 - $652	N/A
Security Health Plan	$301 - $667	N/A
Swedish American	$301 - $667	N/A
Beech Street	$301 - $667	N/A
Private Health Care System	$301 - $667	N/A
Employer's Coalition on Health	$301 - $667	N/A
Benchmark Health	$301 - $667	N/A
Wellmark/Healthnetwork	$307 - $682	N/A
Multiplan	$317 - $704	N/A
Wea Insurance Group	$317 - $704	N/A
Health Smart	$317 - $704	N/A
National Provider Network	$317 - $704	N/A
Integrated Health Plan	$317 - $704	N/A
Unicare	$3,678 - $8,500	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 $376.
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 Ann & Robert H Lurie Childrens Hospital of Chicago 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.