Arkansas · 90732

Pneumococcal Vaccine, 23-Valent in Arkansas

Arkansas Medicare Avg
$127.55
0% below national avg
National Medicare Avg
$127.78
All states combined
Billed Charge (AR)
$174.24
What providers submit
Est. Commercial (AR)
$267.85
National avg: $286.23
Est. Cash / Self-Pay (AR)
$143.58
Typical self-pay discount

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

1.7K
Services in AR
525
Providers
N/A
Min Payment
N/A
Max Payment

Arkansas Pricing in Context

In Arkansas, CPT code 90732 (Pneumococcal Vaccine, 23-Valent) carries an average Medicare payment of $127.55 — 0% below the national benchmark of $127.78. 525 providers across the state submitted claims for this procedure in 2023, performing 1.7K total services. Individual payments in AR 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 Arkansas is $174.24, 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 Arkansas 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 Arkansas lands near $267.85, with self-pay cash prices typically around $143.58. 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, 23-Valent cost in Arkansas?

The average Medicare payment for Pneumococcal Vaccine, 23-Valent in Arkansas is $127.55, which is 0% below the national average of $127.78. Providers in AR typically bill $174.24 for this procedure.

What does Pneumococcal Vaccine, 23-Valent cost with insurance in Arkansas?

With commercial insurance in Arkansas, Pneumococcal Vaccine, 23-Valent costs an estimated $267.85. Without insurance, the estimated cash price is $143.58. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Pneumococcal Vaccine, 23-Valent in Arkansas?

525 providers in Arkansas billed Medicare for Pneumococcal Vaccine, 23-Valent in 2023, performing 1.7K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Pneumococcal Vaccine, 23-Valent cheaper in Arkansas than the national average?

Yes — Pneumococcal Vaccine, 23-Valent costs 0% below the national average in Arkansas. The state average Medicare payment is $127.55 compared to $127.78 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