Tick-borne encephalitis vaccine, 0.25 mL dose

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

TICK-BORNE ENCEPHALITIS VACCINE 1.2 MCG/0.25 ML IM SYRINGE (TICOVAC)

Payers reporting CPT 90626

Payer pricing summary

Low

$69

Average

$871

Median

$500

High

$7.6k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Cigna fee schedule · outpatient · +14 other terms	202	$583	$981	$727	74%	—	$310 – $2.9k
2	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	156	$670	$775	$400	52%	—	$1 – $1.9k
3	Aetna fee schedule · outpatient · +17 other terms	87	$354	$818	$1.2k	147%	—	$10 – $8.4k
4	Anthem fee schedule · outpatient · +14 other terms	60	$334	$403	$214	53%	—	$166 – $1.4k
5	UnitedHealthcare fee schedule · outpatient · +18 other terms	41	$233	$238	$152	64%	—	$16 – $385
6	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$1.1k	$1.0k	$334	33%	—	$410 – $1.7k
7	Molina facility · case rate · outpatient · +12 other terms	29	$26	$60	$45	75%	—	$11 – $175
8	Humana fee schedule · outpatient · +11 other terms	17	$295	$300	$64	21%	—	$174 – $358
9	Caresource facility · case rate · outpatient · +3 other terms	16	$16	$50	$93	183%	—	$10 – $304
10	Medcost professional · percent of total billed charges · outpatientfrom % of charges · +1 other terms	15	$433	$436	$4	1%	—	$433 – $442
11	Medical Mutual professional · percent of total billed charges · outpatientfrom % of charges · +2 other terms	15	$433	$436	$3	1%	—	$433 – $442
12	Healthpartners facility · percent of total billed charges · bothfrom % of charges · +1 other terms	14	$267	$263	$171	65%	—	$95 – $456
13	MultiPlan percent of total billed charges · bothfrom % of charges · +7 other terms	14	$1.4k	$1.6k	$791	49%	—	$577 – $3.8k
14	Wellmark fee schedule · both · +3 other terms	14	$304	$305	$8	2%	—	$295 – $351
15	Optum facility · case rate · outpatient · +6 other terms	13	$15	$26	$23	90%	—	$13 – $79
16	Ucare professional · percent of total billed charges · outpatientfrom % of charges · +1 other terms	13	$433	$430	$31	7%	—	$342 – $456
17	Bcbs Nj fee schedule · outpatient	12	$335	$333	$25	7%	—	$288 – $346
18	Highmark fee schedule · outpatient · +3 other terms	11	$406	$402	$119	30%	—	$14 – $441
19	Medica fee schedule · outpatient · +8 other terms	10	$587	$592	$148	25%	—	$356 – $758
20	Premera fee schedule · outpatient · +2 other terms	9	$624	$573	$95	17%	—	$422 – $742
21	Bcbs Mn fee schedule · both · +2 other terms	8	$298	$298	$3	1%	—	$295 – $301
22	Aetna Better Health fee schedule · inpatient · +5 other terms	7	$304	$304	—	—	—	$304 – $304
23	Amerihealth Caritas facility · case rate · outpatient · +4 other terms	7	$92	$93	$3	3%	—	$92 – $100
24	Bcbs Id percent of total billed charges · bothfrom % of charges · +1 other terms	4	$301	$305	$35	12%	—	$277 – $349
25	First Health facility · fee schedule · outpatient · +8 other terms	4	$717	$717	—	—	—	$717 – $717

Page 1 of 2 · 45 payers