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
Iiv adjuvant vaccine im
Low
$20
Average
$94
Median
$86
High
$214
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
95 hospitals; the 90th percentile is 3.0× 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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207 hospital rates
iThe hospitals that file a Wellmark 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 | Sioux Center Health Sioux Center, IA fee schedule · outpatient | 2 | $83 | $83 | — | — | 832 | $83 – $83 |
| 2 | Avera Holy Family Hospital Estherville, IA fee schedule · outpatient | 2 | $83 | $83 | — | — | 454 | $83 – $83 |
| 3 | Lakes Regional Hospital Spirit Lake, IA fee schedule · outpatient | 2 | $83 | $83 | — | — | 438 | $83 – $83 |
| 4 | Avera McKennan Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $83 | $83 | — | — | 362 | $83 – $83 |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 3 | $83 | $87 | $6 | 7% | 334 | $83 – $97 |
| 6 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $279 | $279 | — | — | 151 | $279 – $279 |
| 7 | Avera St. Luke's Aberdeen, SD fee schedule · outpatient | 1 | $83 | $83 | — | — | 151 | $83 – $83 |
| 8 | Avera St. Mary's Hospital Pierre, SD outpatient | 1 | $279 | $279 | — | — | 124 | $279 – $279 |
| 9 | Avera St. Mary's Hospital Pierre, SD fee schedule · outpatient | 1 | $83 | $83 | — | — | 124 | $83 – $83 |
| 10 | Monument Health Network Inc Custer, SD percent of total billed charges · outpatientfrom % of charges | 2 | $98 | $98 | $55 | 56% | 106 | $44 – $153 |
| 11 | Monument Health Network Inc Sturgis, SD percent of total billed charges · outpatientfrom % of charges | 2 | $88 | $88 | $46 | 53% | 100 | $42 – $134 |
| 12 | Monument Health Network Inc Deadwood, SD percent of total billed charges · outpatientfrom % of charges | 2 | $96 | $96 | $45 | 47% | 58 | $51 – $141 |
| 13 | Avera Creighton Hospital Creighton, NE outpatient | 1 | $88 | $88 | — | — | 54 | $88 – $88 |
| 14 | Avera Creighton Hospital Creighton, NE percent of total billed charges · outpatientfrom % of charges | 1 | $80 | $80 | $2 | 2% | 54 | $78 – $82 |
| 15 | Mercy Health Services-Iowa Corp. Mason City, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $62 | $62 | $34 | 55% | 40 | $28 – $96 |
| 16 | Avera Gregory Hospital Gregory, SD outpatient | 1 | $88 | $88 | — | — | 34 | $88 – $88 |
| 17 | Avera Gregory Hospital Gregory, SD percent of total billed charges · outpatientfrom % of charges | 1 | $75 | $75 | $2 | 2% | 34 | $73 – $77 |
| 18 | Avera Missouri River Health Center Gettysburg, SD outpatient | 1 | $88 | $88 | — | — | 34 | $88 – $88 |
| 19 | Avera Missouri River Health Center Gettysburg, SD percent of total billed charges · outpatientfrom % of charges | 1 | $88 | $88 | — | — | 34 | $88 – $88 |
| 20 | Avera Behavioral Health Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $83 | $83 | — | — | 30 | $83 – $83 |
| 21 | Avera Specialty Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $83 | $83 | — | — | 30 | $83 – $83 |
| 22 | Wagner Community Memorial Wagner, SD outpatient | 1 | $105 | $105 | — | — | 30 | $105 – $105 |
| 23 | Wagner Community Memorial Wagner, SD percent of total billed charges · outpatientfrom % of charges | 1 | $88 | $88 | — | — | 30 | $88 – $88 |
| 24 | Avera Queen of Peace Mitchell, SD outpatient | 1 | $88 | $88 | — | — | 22 | $88 – $88 |
| 25 | Avera Queen of Peace Mitchell, SD fee schedule · outpatient | 1 | $83 | $83 | — | — | 22 | $83 – $83 |
← Payers reporting CPT 90653 · Snapshot 20261111T120946Z-9134e7f7