Hepatitis B immune globulin
Facility: Northeast Regional Medical Center
Billing Code: 90371 (HCPCS)
- CPT Billing Code: 90371
- Insurance Median: $464
- Cash Discount Price: $406
- vs. Medicare Baseline: 3.31x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $140.21 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 331% of the Medicare baseline (a markup of 231%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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) | $138 | 98% |
| UnitedHealthcare | $138 - $771 | 98% |
| Node VA | $138 | 98% |
| Blue Cross Blue Shield | $141 - $313 | 101% |
| Blue Prefrerred | $144 | 103% |
| Blue Pathway/Pathway X | $144 | 103% |
| Blue Access | $144 | 103% |
| Node Devoted Health McR Adv | $145 | 103% |
| Centurion Correctional | $172 | 123% |
| Self Pay | $247 - $565 | 176% |
| Home State Exchange | $248 | 177% |
| Immergrun | $276 | 197% |
| Cigna | $349 - $402 | 249% |
| Aetna | $382 - $857 | 272% |
| Access Health Services, LLC | $668 | 476% |
| Healthlink | $771 - $822 | 550% |
| Multiplan | $771 - $822 | 550% |
| Coventry Wc | $822 | 586% |
Consumer Guidance & Cost Commentary
For patients paying cash directly, the cash rate for Hepatitis B immune globulin at Northeast Regional Medical Center is $406. This amount is notably lower than the facility's gross charge of $1,028 and the median negotiated rate of $464, which is what insurance plans typically pay. While the cash price is lower than the negotiated rates for most commercial payers listed in the data, such as Aetna's high of $857 and UnitedHealthcare's high of $771, it is important to note that many of these commercial rates are already below the facility's gross charge. Patients with high-deductible plans may find that paying the $406 cash rate upfront is more cost-effective than having their insurance process a claim, especially if their plan's allowed amount or deductible makes the out-of-pocket cost higher than the cash price.
The facility is located in Kirksville, Missouri, and operates under a proprietary ownership model with a facility rating of 2. The data indicates that the cash rate of $406 is the primary benchmark for self-pay patients, as the median negotiated rate of $464 and the gross charge of $1,028 represent different payment structures. Although specific county or state average rates are not provided in the available data, patients should be aware that the cash rate of $406 is significantly lower than the facility's gross charge and the median negotiated rate of $464. To minimize costs, patients should verify if the facility offers prompt-pay discounts, which can further reduce the $406 cash rate, and ensure they request a self-pay classification before check-in to avoid automatic claims submission that could void cash discounts