CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Children's Hospital of Philadelphia

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $485
Cash Discount Price: $1,223
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Children's Hospital of Philadelphia is $485. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,223. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$1,223

Average discount available for prompt cash payment at this facility.

Insurance Median

$485

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
Geisinger Medical Assistance	$14	N/A
Horizon Nj Health	$196	N/A
Medicaid / KanCare	$202	N/A
UnitedHealthcare	$203 - $673	N/A
Health Partners	$213	N/A
Keystone Health Plan East	$279	N/A
Blue Cross Blue Shield	$279 - $432	N/A
Aetna	$322 - $611	N/A
Highmark Wholecare	$334	N/A
UPMC Medical Assistance	$334	N/A
Keystone First Chip	$379	N/A
Geisinger Health Plan Commercial	$538	N/A
Jefferson Health Plans	$578	N/A
Highmark	$611	N/A
Cigna	$611	N/A
Qualcare	$673	N/A
First Health Network	$795	N/A
Private Health Care Systems	$978	N/A
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$978	N/A
Choice Care Network	$1,101	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 $1,223.
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 Children's Hospital of Philadelphia 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.