CPT 90655
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
Iiv3 vacc no prsv 0.25 ml im
Low
$0
Average
$176
Median
$14
High
$3.3k
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24 hospital rates
iThe hospitals that file a Ambetter 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 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 2 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $5 | $5 | $2 | 44% | — | $3 – $7 |
| 3 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 4 | Beatrice Community Hospital Beatrice, NE percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | $6 | 21% | — | $22 – $34 |
| 5 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Florida Coast Medical and Surgical Center, Inc. Port St. Lucie, FL case rate · outpatient | 3 | $0 | $0 | $0 | 14% | — | $0 – $0 |
| 9 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 10 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 11 | Jasper Health Services Monticello, GA percent of total billed charges · outpatientfrom % of charges | 1 | $62 | $62 | — | — | — | $62 – $62 |
| 12 | Little Company of Mary Hospital of Indiana Inc Jasper, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $9 | $9 | $7 | 79% | — | $2 – $17 |
| 13 | OCHSNER MEDICAL CENTER � HANCOCK LLC Bay St. Louis, MS other · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 14 | Piedmont Athens Regional Athens, GA percent of total billed charges · bothfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 15 | Piedmont Augusta Augusta, GA percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 16 | Piedmont Columbus Regional - Midtown Columbus, GA percent of total billed charges · bothfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 17 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS percent of total billed charges · bothfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 18 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CANTON, MS percent of total billed charges · bothfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 19 | Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO percent of total billed charges · outpatientfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 20 | THE COMMUNITY HOSPITAL OF BRAZOSPORT Lake Jackson, TX fee schedule · inpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | THE COMMUNITY HOSPITAL OF BRAZOSPORT Lake Jackson, TX fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 22 | The Medical Center of Central Georgia Inc Macon, GA percent of total billed charges · inpatientfrom % of charges | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 23 | The Medical Center of Central Georgia Inc Macon, GA percent of total billed charges · outpatientfrom % of charges | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 24 | University Medical Center of Southern Nevada Las Vegas, NV fee schedule · both | 1 | $24 | $24 | — | — | — | $24 – $24 |
← Payers reporting CPT 90655 · Snapshot 20261113T090226Z-3ce6c0b8