CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Mount Desert Island Hospital

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $225
Cash Discount Price: $324
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Mount Desert Island Hospital is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $324. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 10 Wayman Lane, Bar Harbor, ME.

Cash / Self-Pay

$324

Average discount available for prompt cash payment at this facility.

Insurance Median

$225

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
Wellcare	$162	N/A
Aetna	$162 - $329	N/A
Martins Point	$162	N/A
Cigna	$162 - $335	N/A
UnitedHealthcare	$162 - $216	N/A
Blue Cross Blue Shield	$162 - $280	N/A
Healthnet	$234	N/A
Community Health Options	$306	N/A
Harvard Pilgrim	$326	N/A
First Health	$342	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 $324.
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 Mount Desert Island Hospital 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.