Meningococcal five-strain vaccine (A, B, C, W, Y) injection

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

MENINGOCOCC VAC A,C,Y,W135,CONJ TET COMPONENT(PF) SUSP (PENBRAYA)

Payers reporting CPT 90623

Payer pricing summary

Low

$36

Average

$1.2k

Median

$255

High

$33.5k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +13 other terms	101	$237	$240	$22	9%	1–10	$163 – $307
2	UnitedHealthcare fee schedule · outpatient · +18 other terms	383	$498	$499	$233	47%	—	$8 – $1.7k
3	Cigna fee schedule · outpatient · +14 other terms	195	$496	$772	$568	74%	—	$235 – $2.3k
4	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	167	$560	$666	$349	52%	—	$1 – $1.6k
5	Aetna fee schedule · outpatient · +17 other terms	83	$340	$735	$1.2k	165%	—	$10 – $8.4k
6	Anthem fee schedule · outpatient · +10 other terms	58	$254	$310	$155	50%	—	$166 – $1.2k
7	Caresource fee schedule · outpatient · +6 other terms	39	$249	$250	$8	3%	—	$242 – $271
8	Molina facility · case rate · outpatient · +11 other terms	27	$25	$58	$46	79%	—	$11 – $175
9	Bcbs Tx fee schedule · outpatient · +1 other terms	18	$738	$758	$236	31%	—	$392 – $1.2k
10	Wellmark fee schedule · both · +5 other terms	14	$231	$232	$8	3%	—	$231 – $280
11	Aetna Better Health fee schedule · outpatient · +4 other terms	13	$285	$264	$23	9%	—	$239 – $285
12	Optum facility · case rate · outpatient · +2 other terms	13	$15	$26	$23	90%	—	$13 – $79
13	Amerihealth Caritas facility · fee schedule · outpatient · +4 other terms	12	$12	$12	$0	1%	—	$12 – $12
14	Bcbs Nj fee schedule · outpatient	12	$256	$255	$14	5%	—	$230 – $263
15	Highmark facility · fee schedule · outpatient · +4 other terms	12	$12	$100	$147	148%	—	$12 – $385
16	Medica fee schedule · both · +5 other terms	9	$246	$246	$11	4%	—	$231 – $257
17	Ucare fee schedule · both · +3 other terms	9	$221	$221	—	—	—	$221 – $221
18	Bcbs Il professional · fee schedule · both	8	$70	$82	$125	152%	—	$0 – $280
19	Bcbs Mn fee schedule · both · +2 other terms	8	$242	$242	$7	3%	—	$235 – $251
20	First Health professional · fee schedule · both · +7 other terms	8	$1	$106	$136	128%	—	$1 – $282
21	WellCare professional · fee schedule · both · +3 other terms	8	$18	$26	$70	264%	—	$0 – $212
22	Ambetter professional · fee schedule · both · +5 other terms	4	$0	$0	—	—	—	$0 – $0
23	Medicaid case rate · outpatient · +3 other terms	4	$60	$60	—	—	—	$60 – $60
24	Excellus facility · fee schedule · outpatient · +3 other terms	3	$242	$242	—	—	—	$242 – $242
25	Sanford Health Plan fee schedule · outpatient · +1 other terms	3	$242	$242	—	—	—	$242 – $242

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