CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Preston Memorial Hospital

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $248
Cash Discount Price: $166
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Preston Memorial Hospital is $248. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 150 Memorial Drive, Kingwood, WV.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$248

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
Unicare	$103	N/A
Uhc_Va	$185 - $214	N/A
Aetna	$185 - $321	N/A
Humana	$185 - $214	N/A
Medicare (plans)	$185 - $289	N/A
Advantra	$185 - $214	N/A
UPMC	$194 - $225	N/A
Medicaid / KanCare	$200 - $243	N/A
Blue_Cross_Highmark_Aca	$224 - $259	N/A
Blue_Cross_Highmark_Ppo	$248 - $288	N/A
Blue_Cross_Highmark_Pos	$248 - $288	N/A
Blue_Cross_Highmark_Traditional	$273 - $316	N/A
UnitedHealthcare	$277 - $321	N/A
Cigna	$283 - $328	N/A
Geha	$292 - $339	N/A
4_Most	$299 - $346	N/A
Health	$299 - $346	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 $166.
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 Preston Memorial Hospital 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.