CMS Price Transparency Data

Pneumococcal vaccine

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $69
Cash Discount Price: $75
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at UPMC Children's Hospital of Pittsburgh is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$75

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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 (%)

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$31 - $147	N/A
Health Partners Plans (Jefferson Health Plan)	$39	N/A
Blue Cross Blue Shield	$40 - $62	N/A
UnitedHealthcare	$40 - $527	N/A
Geisinger	$41 - $56	N/A
PA Health & Wellness	$50	N/A
Amerihealth Caritas	$51	N/A
Cigna	$59 - $69	N/A
Health Plan of Upper Ohio Valley	$81 - $147	N/A
Intergroup	$81 - $106	N/A
Saudi Armed Forces	$100	N/A
Coventry/First Health	$100	N/A
Health Payors Organization	$106	N/A
Multiplan	$106	N/A
National Provider Network	$112	N/A
Private Health Care Systems	$112	N/A
Highmark Wholecare (Prev Gateway)	$133	N/A
UPMC Health Plan	$147 - $190	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 $75.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90732.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Children's Hospital of Pittsburgh is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90732.
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.