CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Hospital for Special Surgery

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $176
Cash Discount Price: $232
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Hospital for Special Surgery is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $232. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 535 East 70Th Street, New York, NY.

Cash / Self-Pay

$232

Average discount available for prompt cash payment at this facility.

Insurance Median

$176

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
Blue Cross Blue Shield	$102 - $179	N/A
Cigna	$158 - $176	N/A
Apwu [1016]	$158 - $176	N/A
Qualcare [1101]	$158 - $176	N/A
Nalc [1090]	$158 - $176	N/A
Wellfleet [1361]	$158 - $176	N/A
Emblem Health [1043]	$179	N/A
Connecticare [1039]	$179	N/A
Aetna	$215	N/A
Nippon Life [1092]	$215	N/A
Christian Brothers [1034]	$215	N/A
Meritain Health [1085]	$215	N/A
Webtpa [1356]	$215	N/A
Affinity By Molina Health Plan [1005]	$224	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 $232.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90716.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hospital for Special Surgery is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90716.
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.