CMS Price Transparency Data

Rabies immune globulin

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 90375 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90375
Insurance Median: $684
Cash Discount Price: $481
vs. Medicare Baseline: 2.49x Medicare

The contracted insurance negotiated median rate for a Rabies immune globulin at Mary Hitchcock Memorial Hospital is $684. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $481. Compared to the federal Medicare reimbursement reference rate of $275.18, this hospital’s rate is 2.49x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$481

Average discount available for prompt cash payment at this facility.

Insurance Median

$684

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$275.18

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $275.18 (100%)

Cash / Self-Pay: $481 (175%)

Insurance Median: $684 (249%)

Cash: $481 (175% of Medicare)

Ins. Median: $684 (249% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $275.18 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 249% of the Medicare baseline (a markup of 149%). 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
Amerihealth Caritas Nh	$89 - $890	32%
Beacon Health Strategies/Carelon	$96 - $959	35%
Wellsense Health Plan	$96 - $959	35%
Granite State Health Plan	$99 - $989	36%
Harvard Pilgrim Health Care of Ne	$182 - $5,038	66%
Blue Cross Blue Shield	$186 - $6,844	68%
Aetna	$267 - $5,513	97%
Martin's Point Health Care	$271 - $2,709	98%
Mvp	$280 - $5,262	102%
UnitedHealthcare	$280 - $6,031	102%
Martin's Point Generations Advantage	$280	102%
Cigna	$288 - $5,387	105%
Wellcare Health Plans	$291	106%
Ambetter / Centene	$294 - $920	107%
Tufts Health Plan	$335 - $4,582	122%
Mass General Brigham Health Plan	$451 - $4,885	164%
Maine Community Health Options	$500 - $5,772	182%
First Health/Hcvm	$683 - $6,833	248%
Coventry	$683 - $6,833	248%
PHCS	$707 - $7,068	257%
Corvel	$723 - $7,225	263%
Ccmsi	$746 - $7,461	271%

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 $481.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90375.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mary Hitchcock Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90375.
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.