CPT 90650
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
2vhpv vaccine 3 dose im
Low
$25
Average
$2.6k
Median
$907
High
$37.5k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
20 hospitals; the 90th percentile is 12.0× 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.
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20 hospital rates
iThe hospitals that file a Tricare 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 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $37.5k | $37.5k | — | — | — | $37.5k – $37.5k |
| 2 | Bluffton Health System LLC Bluffton, IN facility · fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 3 | Dupont Hospital LLC Wayne, IN facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 4 | Durant HMA LLC Durant, OK facility · fee schedule · outpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 5 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 6 | HMA Santa Rosa Medical Center LLC Milton, FL facility · fee schedule · outpatient | 1 | $545 | $545 | — | — | — | $545 – $545 |
| 7 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $201 | $201 | — | — | — | $201 – $201 |
| 8 | HSA CGH LLC Coral Gables, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 9 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 10 | IOM Health System LP Fort Wayne, IN facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 11 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · fee schedule · outpatient | 1 | $898 | $898 | — | — | — | $898 – $898 |
| 12 | MCLAREN CARO REGION CARO, MI fee schedule | 1 | $230 | $230 | — | — | — | $230 – $230 |
| 13 | MCLAREN THUMB REGION AXE, MI fee schedule | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 14 | Mat-Su Valley Medical Center LLC Palmer, AK facility · fee schedule · outpatient | 1 | $442 | $442 | — | — | — | $442 – $442 |
| 15 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 16 | Poplar Bluff Regional Medical Center LLC Poplar Bluff, MO facility · fee schedule · outpatient | 1 | $917 | $917 | — | — | — | $917 – $917 |
| 17 | Roswell Hospital Corporation Roswell, NM facility · fee schedule · outpatient | 1 | $734 | $734 | — | — | — | $734 – $734 |
| 18 | St. Joseph Health System, LLC Wayne, IN facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 19 | Warsaw Health System LLC Warsaw, IN facility · fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 20 | Westchester Medical Center Valhalla, NY facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
← Payers reporting CPT 90650 · Snapshot 20261113T090226Z-3ce6c0b8