CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Ira Davenport Memorial Hospital

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90371
  • Insurance Median: $145
  • Cash Discount Price: $194
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Ira Davenport Memorial Hospital is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 1.03x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.
Cash / Self-Pay
$194

Average discount available for prompt cash payment at this facility.

Insurance Median
$145

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: $194 (138%)
Insurance Median: $145 (103%)
Cash: $194 (138% of Medicare)
Ins. Median: $145 (103% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Fidelis Care - Exchange - All Plans $107 76%
Geisinger - All Plans $113 81%
Blue Cross Blue Shield $119 - $1,162 85%
Mvp Health Plan - All Plans $121 86%
Cigna $121 86%
Independent Health - All Plans $126 90%
UPMC - All Plans $134 96%
Tricare $134 96%
Humana $134 - $175 96%
Amerihealth Caritas McR Adv - All Plans $136 97%
Pomco Inc - All Plans $140 100%
Fidelis $145 103%
UnitedHealthcare $146 104%
Aetna $146 - $207 104%
Empire $163 116%
Emblem Health - All Plans $171 122%
Martins Point - All Plans $194 138%
Healthnow - All Plans $640 456%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7571 State Route 54, Bath, NY 14810
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Rural Emergency Hospital