CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Boston Children's Hospital

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $16
Cash Discount Price: $11
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Boston Children's Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$11

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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
Cdphp	$10 - $18	N/A
Harvard Pilgrim	$11 - $14	N/A
Blue Cross Blue Shield	$12 - $23	N/A
Aetna	$12 - $17	N/A
United	$12 - $17	N/A
Mgb/Allways	$13 - $15	N/A
UnitedHealthcare	$13 - $18	N/A
Carelon Strategies/Bhs	$13	N/A
Ambetter / Centene	$13	N/A
United Ri Nj Ny	$13	N/A
Tufts Public Plan	$13	N/A
Fallon	$16	N/A
Carelon/Beacon	$16	N/A
Health New England	$17	N/A
Interlink Transplant	$18	N/A
Cigna	$18 - $19	N/A
Ets/Lifetrac	$18	N/A
Coventry/Hcvm/First Health	$19	N/A
Humana	$19	N/A
Community Health Options	$19	N/A
Multiplan/Phcs	$19 - $20	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 $11.
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 Boston Children's 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.