Each additional childhood vaccine given during an unscheduled visit

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Im Adm Thru 18yr Any Rte Addl Vac/Tox Compt

Medicaid pricing summary

Low

Average

$13

Median

$10

High

$48

Medicaid rate distribution

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41 hospital rates

#		Plans
1	BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both	2	$27	$27	$1	5%	—	$25 – $28
2	Berkshire Medical Center Great Barrington, MA professional · fee schedule · outpatient	2	$10	$10	—	—	—	$10 – $10
3	CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient	1	$7	$7	—	—	—	$7 – $7
4	Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient	2	$1	$1	—	—	—	$1 – $1
5	Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient	2	$1	$1	—	—	—	$1 – $1
6	Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient	1	$27	$27	—	—	—	$27 – $27
7	Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both	1	$11	$11	—	—	—	$11 – $11
8	Fairview Hospital Great Barrington, MA professional · fee schedule · outpatient	2	$10	$10	—	—	—	$10 – $10
9	Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both	1	$7	$7	—	—	—	$7 – $7
10	Hospital Authority of Colquitt County Moultrie, GA fee schedule · both	1	$48	$48	$2	3%	—	$46 – $49
11	INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient	1	$27	$27	—	—	—	$27 – $27
12	Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · inpatient	1	$11	$11	—	—	—	$11 – $11
13	Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · outpatient	1	$11	$11	—	—	—	$11 – $11
14	Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$7	$7	—	—	—	$7 – $7
15	Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$3	$3	—	—	—	$3 – $3
16	Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$2	$2	—	—	—	$2 – $2
17	Mercy Hospital Southeast Girardeau, MO professional · fee schedule · inpatient	1	$10	$10	—	—	—	$10 – $10
18	Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient	1	$10	$10	—	—	—	$10 – $10
19	Mercy Hospital Southeast Girardeau, MO professional · fee schedule · inpatient	1	$10	$10	—	—	—	$10 – $10
20	Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient	1	$10	$10	—	—	—	$10 – $10
21	Mercy Hospitals East Communities dba Mercy Hospital Washington Washington, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$3	$3	—	—	—	$3 – $3
22	Mercy Medical Center - Dubuque Dubuque, IA professional · fee schedule · inpatient	1	$9	$9	—	—	—	$9 – $9
23	Mercy Medical Center - Dubuque Dubuque, IA professional · fee schedule · outpatient	1	$11	$11	—	—	—	$11 – $11
24	Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$0	$0	—	—	—	$0 – $0
25	Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both	1	$8	$8	—	—	—	$8 – $8