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.
Original text from hospital filings
Menb-4c Recombnt Prot & Outer Memb Vesic Vacc Im
Low
$0
Average
$439
Median
$377
High
$6.6k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
1371 hospitals; the 90th percentile is 5.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
2,058 hospital rates
iThe hospitals that file a UnitedHealthcare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA fee schedule · both | 1 | $341 | $341 | — | — | 570 | $341 – $341 |
| 2 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 3 | $249 | $248 | $27 | 11% | 182 | $214 – $280 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · percent of total billed charges · outpatientfrom % of charges | 2 | $499 | $499 | — | — | 182 | $499 – $499 |
| 4 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 2 | $254 | $254 | — | — | 130 | $254 – $254 |
| 5 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $333 | $333 | — | — | 91–100 | $333 – $333 |
| 6 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 3 | $248 | $235 | $30 | 13% | 77–86 | $194 – $262 |
| 7 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $333 | $333 | — | — | 56 | $333 – $333 |
| 8 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 5 | $244 | $249 | $17 | 7% | 43–52 | $230 – $268 |
| 9 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 2 | $254 | $254 | — | — | 32 | $254 – $254 |
| 10 | Duke University Hospital Durham, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $558 | $577 | $315 | 55% | 31–49 | $263 – $931 |
| 11 | Duke University Hospital Raleigh, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $558 | $577 | $315 | 55% | 31–49 | $263 – $931 |
| 12 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 3 | $385 | $420 | $74 | 18% | 28–46 | $353 – $522 |
| 13 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 2 | $212 | $212 | — | — | 24 | $212 – $212 |
| 14 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 2 | $285 | $285 | — | — | 19–28 | $285 – $285 |
| 15 | WINNESHIEK MEDICAL CENTER Decorah, IA percent of total billed charges · outpatientfrom % of charges | 1 | $241 | $241 | — | — | 13 | $241 – $241 |
| 16 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $249 | $249 | — | — | 12 | $249 – $249 |
| 17 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $472 | $472 | — | — | 5–50 | $472 – $472 |
| 18 | Fairview Health Services Minneapolis, MN other · outpatient | 1 | $472 | $472 | — | — | 5–50 | $472 – $472 |
| 19 | Mayo Clinic Health System Barron, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $231 | $226 | $72 | 32% | 3–30 | $82 – $288 |
| 20 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $355 | $400 | $75 | 19% | 2–20 | $338 – $506 |
| 21 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $213 | $213 | $195 | 91% | 2–20 | $19 – $408 |
| 22 | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA percent of total billed charges · outpatientfrom % of charges | 1 | $774 | $774 | $277 | 36% | 2–20 | $497 – $1.1k |
| 23 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $483 | $651 | $237 | 36% | 2–20 | $483 – $986 |
| 24 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 2 | $254 | $254 | — | — | 2–20 | $254 – $254 |
| 25 | REEDLEY COMMUNITY HOSPITAL Reedley, CA percent of total billed charges · outpatientfrom % of charges | 1 | $167 | $167 | — | — | 2–20 | $167 – $167 |
← Payers reporting CPT 90620 · Snapshot 20261112T124536Z-e251e855