CMS Price Transparency Data

Pneumococcal vaccine

Facility: Lewisgale Medical Center

Billing Code: 90732 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90732
Insurance Median: $275
Cash Discount Price: $382
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Pneumococcal vaccine at Lewisgale Medical Center is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $382. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1900 Electric Road, Salem, VA.

Cash / Self-Pay

$382

Average discount available for prompt cash payment at this facility.

Insurance Median

$275

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
Cigna	$66 - $168	N/A
Triatlantic	$113	N/A
Health Net	$120	N/A
Humana	$129	N/A
Virginia Health Network	$134 - $271	N/A
United	$139 - $400	N/A
Naphcare	$191	N/A
Greenvbrier Sporting Club	$229	N/A
Graham-White Manufacturing	$267	N/A
Richfield Nursing Center	$267	N/A
Corvel	$275	N/A
Community Care Network	$286	N/A
Richfield Retirement Community	$286	N/A
One Health Plan	$306	N/A
Occunet Workers Comp	$306	N/A
Csx Hotels	$306	N/A
Patients Choice	$336	N/A
C&O Employees Hospital Assn	$344	N/A
American Postal Workers Union	$344	N/A
Multiplan	$344	N/A
Alleghany Highland Community	$344	N/A
PHCS	$344	N/A
4Most	$344	N/A
Star Transportation	$344	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 $382.
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 Lewisgale Medical Center 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.