CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Sanford Usd Medical Center

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $333
Cash Discount Price: $386
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Sanford Usd Medical Center is $333. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $386. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.

Cash / Self-Pay

$386

Average discount available for prompt cash payment at this facility.

Insurance Median

$333

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
Health Partners	$162 - $188	N/A
Blue Cross Blue Shield	$178	N/A
Sanford Health Plan	$196	N/A
Security Health Plan	$266	N/A
UnitedHealthcare	$325 - $426	N/A
Medica	$326 - $348	N/A
Ucare	$340	N/A
Aetna	$370	N/A
Multiplan	$435	N/A
Healthez	$435	N/A
First Choice Health Network	$435	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 $386.
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 Sanford Usd Medical Center 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.