CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Margaretville Memorial Hospital

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $10
Cash Discount Price: $23
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Margaretville Memorial Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$23

Average discount available for prompt cash payment at this facility.

Insurance Median

$10

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
Self-Pay	$3 - $12	N/A
Medicare (plans)	$3 - $23	N/A
Blue Cross Blue Shield	$3 - $15	N/A
Mvp Exchange	$3 - $13	N/A
Aetna	$3 - $15	N/A
Mvp Hmo/Ppo	$3 - $13	N/A
Emblem Ghi/Hip Ppo/Cbp	$4 - $12	N/A
Hamaspik (McR)	$4 - $15	N/A
UnitedHealthcare	$4 - $15	N/A
Mvp Gold (McR)	$4 - $15	N/A
Magnacare Standard	$4 - $12	N/A
Emblem Select Care (Exchange)	$4 - $12	N/A
Oxford Exchange	$4 - $12	N/A
Emblem Ghi/Hip Hmo/Epo/Pos	$4 - $12	N/A
Cdphp	$5 - $17	N/A
Affinity By Molina McR	$5 - $16	N/A
Todays Options	$7 - $25	N/A
Magnacare Preferred	$8 - $28	N/A
Multiplan	$8 - $29	N/A
First Health	$9 - $32	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 $23.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90656.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Margaretville Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90656.
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.