CMS Price Transparency Data

Pneumococcal vaccine

Facility: Sanford Westbrook Medical Center

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90732
  • Insurance Median: $229
  • Cash Discount Price: $219
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Pneumococcal vaccine at Sanford Westbrook Medical Center is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 920 Bell Avenue Po Box 188, Westbrook, MN.
Cash / Self-Pay
$219

Average discount available for prompt cash payment at this facility.

Insurance Median
$229

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

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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
Blue Cross Blue Shield $66 - $254 N/A
Sanford Health Plan Align $117 N/A
Ucare $126 - $241 N/A
Wellmark Sd $126 N/A
Aetna $127 - $238 N/A
Medicare (plans) $127 N/A
UnitedHealthcare $127 - $229 N/A
Health Partners $127 - $219 N/A
Primewest $130 - $139 N/A
Security Health Plan $151 N/A
Sanford Health Plan $217 - $255 N/A
Medica $241 - $260 N/A
Healthez $247 N/A
First Choice Health Network $247 N/A
Cigna $247 N/A
Multiplan $247 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 920 Bell Avenue Po Box 188, Westbrook, MN 56183
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals