CMS Price Transparency Data

Pneumococcal vaccine

Facility: Lafayette Regional Health Center

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $427
Cash Discount Price: $869
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Lafayette Regional Health Center is $427. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $869. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1500 State Street, Lexington, MO.

Cash / Self-Pay

$869

Average discount available for prompt cash payment at this facility.

Insurance Median

$427

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
Ambetter / Centene	$106 - $218	N/A
United	$133 - $526	N/A
Healthyblue	$136	N/A
Medicaid / KanCare	$137	N/A
Amerigroup	$139	N/A
Unicare	$139	N/A
Aetna	$139 - $1,023	N/A
Home State Health Plan	$139	N/A
Humana	$192 - $503	N/A
Blue Cross Blue Shield	$216 - $748	N/A
Oha Network	$285 - $585	N/A
Oscar	$285 - $585	N/A
Cigna	$325 - $835	N/A
Wppa Providrs Care Network	$427 - $877	N/A
Multiplan	$444 - $912	N/A
Coventry Kc Mo	$454 - $933	N/A
Coventry	$454 - $933	N/A
Cco, Inc.	$484 - $994	N/A
Corvel Corporation	$484 - $994	N/A
Focus Healthcare Mgmt, Inc	$513 - $1,052	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 $869.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90732.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lafayette Regional Health Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90732.
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.