CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Vidant Roanoke Chowan Hospital

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90371
Insurance Median: $731
Cash Discount Price: $1,911
vs. Medicare Baseline: 5.21x Medicare

The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Vidant Roanoke Chowan Hospital is $731. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,911. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 5.21x the Medicare baseline. Located in 500 S Academy St, Ahoskie, NC.

Cash / Self-Pay

$1,911

Average discount available for prompt cash payment at this facility.

Insurance Median

$731

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$140.21

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $140.21 (100%)

Cash / Self-Pay: $1,911 (1363%)

Insurance Median: $731 (521%)

Cash: $1,911 (1363% of Medicare)

Ins. Median: $731 (521% of 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 521% of the Medicare baseline (a markup of 421%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$180 - $1,691	128%
Carolina Complete Health [1317]	$181 - $767	129%
Wellcare [1320]	$182 - $771	130%
Amerihealth McAid Adv [1316]	$183 - $775	131%
Nc Dept of Public Safety [1095]	$266 - $1,125	190%
UnitedHealthcare	$403 - $1,707	287%
Medcost [1067]	$452 - $2,016	322%
Aetna	$458 - $2,529	327%
Cigna	$621 - $2,968	443%
Multiplan [1031]	$694 - $2,937	495%

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 $1,911.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90371.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Vidant Roanoke Chowan Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90371.
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.