CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Northeast Regional Medical Center

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $45
Cash Discount Price: $45
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Northeast Regional Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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
Medicare (plans)	$22	N/A
Node Hospice Non Par Agree	$23	N/A
Node Champva	$23	N/A
Node Devoted Health McR Adv	$23	N/A
Tricare	$23	N/A
Blue Cross Blue Shield	$23 - $35	N/A
UnitedHealthcare	$23 - $85	N/A
Node VA	$23	N/A
Blue Access	$25	N/A
Blue Prefrerred	$25	N/A
Blue Pathway/Pathway X	$25	N/A
Self Pay	$27 - $62	N/A
Centurion Correctional	$28	N/A
Cigna	$39 - $44	N/A
Home State Exchange	$41	N/A
Aetna	$42 - $95	N/A
Naphcare	$43	N/A
Immergrun	$45	N/A
Access Health Services, LLC	$74	N/A
Multiplan	$85 - $91	N/A
Healthlink	$85 - $91	N/A
Coventry Wc	$91	N/A

Consumer Guidance & Cost Commentary

For patients paying out of pocket, the cash price for this Flu vaccine (high dose) service at Northeast Regional Medical Center is $45, which is significantly lower than the facility's gross charge of $113. While commercial insurance plans often pay negotiated rates that can exceed the cash price due to administrative overhead and contract structures, self-pay patients may find it more cost-effective to pay directly, provided they verify if their specific plan requires them to meet a deductible first. It is advisable to contact the hospital before scheduling to confirm availability of self-pay or prompt-pay discounts, which can further reduce the final amount owed by bypassing standard insurance billing cycles.

The facility's negotiated rates vary widely among payers, ranging from a low of $23 to a high of $95, with the median negotiated rate set at $45. This aligns with the facility's cash median but differs from the broader market context where the gross charge reaches $113. Since Medicare rates are not available for this specific service, patients should rely on comparing the facility's cash rate against their own plan's deductible status and out-of-pocket maximums to determine the most economical path. Ultimately, understanding that in-network status does not guarantee the lowest possible price encourages patients to actively compare allowed amounts across different carriers before finalizing their care.

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 $45.
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 Northeast Regional Medical Center 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.