CMS Price Transparency Data

Hepatitis B immune globulin

Facility: Intermountain Health Sanpete Valley Hospital

Billing Code: 90371 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90371
  • Insurance Median: $2,403
  • Cash Discount Price: $1,897
  • vs. Medicare Baseline: 17.14x Medicare
The contracted insurance negotiated median rate for a Hepatitis B immune globulin at Intermountain Health Sanpete Valley Hospital is $2,403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,897. Compared to the federal Medicare reimbursement reference rate of $140.21, this hospital’s rate is 17.14x the Medicare baseline. Located in 1100 South Medical Drive, Mount Pleasant, UT.
Cash / Self-Pay
$1,897

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,403

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: $1,897 (1353%)
Insurance Median: $2,403 (1714%)
Cash: $1,897 (1353% of Medicare)
Ins. Median: $2,403 (1714% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1714% of the Medicare baseline (a markup of 1614%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Selecthealth $128 - $2,403 91%
Blue Cross Blue Shield $128 - $2,403 91%
Molina $128 - $2,403 91%
Health Plan of Nevada $128 - $2,251 91%
Healthy U $128 - $2,251 91%
Humana $128 - $2,403 91%
American Health $128 - $759 91%
Aetna $128 - $2,428 91%
UnitedHealthcare $128 - $2,403 91%
Health Partners of Nevada $128 - $759 91%
Triwest $788 - $2,284 562%
Injury Care of Nevada $1,897 1353%
Wcf Insurance $2,150 1533%
Byu Risk Management $2,150 1533%
Corvel Corporation $2,150 1533%
Corporation of the President $2,150 1533%
Awh Connected $2,403 - $2,428 1714%
Prodegi Corp Benefit $2,403 1714%
Global Excel $2,403 1714%
Tanner LLC $2,403 1714%
Wise Network $2,403 1714%
Cigna $2,403 1714%
Health Utah $2,403 1714%
Emi Health $2,403 1714%
Ifit $2,403 1714%
Emi $2,403 1714%
Byu Athletics $2,403 1714%
Franklin County $2,403 1714%
Campbell Scientific $2,403 1714%
Juniper Systems $2,403 1714%
Hygeia Corporation $2,403 1714%
Springtide $2,403 1714%
Deseret Mutual $2,403 1714%
Utah Tech $2,403 1714%
Motivhealth $2,403 1714%
Medcare International $2,403 1714%
Lw Miller $2,403 1714%
Pehp $2,403 1714%
Uofu $2,403 1714%
Managed Care Admin $2,403 1714%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 South Medical Drive, Mount Pleasant, UT 84647
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals