CMS Price Transparency Data

Flu vaccine (high dose)

Facility: Stonewall Jackson Memorial Hospital

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $107
Cash Discount Price: $59
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at Stonewall Jackson Memorial Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 230 Hospital Plaza, Weston, WV.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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
Aetna	$18 - $95	N/A
Humana	$22	N/A
Ves	$22	N/A
Umwa	$22	N/A
Universal_Health	$23	N/A
Blue Cross Blue Shield	$99 - $106	N/A
Onenet	$102	N/A
Cigna	$106 - $107	N/A
Healthsmart_Ppo	$106 - $107	N/A
Healthsmart_Hpo	$106 - $107	N/A
Healthsmart_Auto	$106 - $107	N/A
Sharpe	$106 - $107	N/A
Healthsmart_Accel	$106 - $107	N/A
UnitedHealthcare	$109 - $110	N/A
Ccn	$112 - $113	N/A
Multiplan	$112 - $113	N/A
Alliance_Ppo	$112 - $113	N/A
4_Most	$115 - $116	N/A
Napp	$115	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 $59.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90656.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Stonewall Jackson Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90656.
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.