Alaska · 90670

Pneumococcal Vaccine, 13-Valent in Alaska

Alaska Medicare Avg
$222.47
10% below national avg
National Medicare Avg
$246.24
All states combined
Billed Charge (AK)
$262.28
What providers submit
Est. Commercial (AK)
$556.18
National avg: $551.57
Est. Cash / Self-Pay (AK)
$238.98
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

54
Services in AK
27
Providers
N/A
Min Payment
N/A
Max Payment

Alaska Pricing in Context

In Alaska, CPT code 90670 (Pneumococcal Vaccine, 13-Valent) carries an average Medicare payment of $222.47 — 10% below the national benchmark of $246.24. 27 providers across the state submitted claims for this procedure in 2023, performing 54 total services. Individual payments in AK ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Alaska is $262.28, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Alaska sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Vaccines & Injections procedures, the estimated commercial insurance price in Alaska lands near $556.18, with self-pay cash prices typically around $238.98. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Pneumococcal Vaccine, 13-Valent cost in Alaska?

The average Medicare payment for Pneumococcal Vaccine, 13-Valent in Alaska is $222.47, which is 10% below the national average of $246.24. Providers in AK typically bill $262.28 for this procedure.

What does Pneumococcal Vaccine, 13-Valent cost with insurance in Alaska?

With commercial insurance in Alaska, Pneumococcal Vaccine, 13-Valent costs an estimated $556.18. Without insurance, the estimated cash price is $238.98. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Pneumococcal Vaccine, 13-Valent in Alaska?

27 providers in Alaska billed Medicare for Pneumococcal Vaccine, 13-Valent in 2023, performing 54 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Pneumococcal Vaccine, 13-Valent cheaper in Alaska than the national average?

Yes — Pneumococcal Vaccine, 13-Valent costs 10% below the national average in Alaska. The state average Medicare payment is $222.47 compared to $246.24 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial