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
$7
Average
$152
Median
$14
High
$2.2k
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16 hospital rates
iThe hospitals that file a Medicare 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 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 2 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $7 | $7 | $3 | 45% | — | $4 – $10 |
| 3 | FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN percent of total billed charges · bothfrom % of charges | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 4 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 5 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 6 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 7 | SAN MIGUEL HOSPITAL CORPORATION LAS VEGAS, NM percent of total billed charges · bothfrom % of charges | 6 | $31 | $30 | $1 | 5% | — | $27 – $31 |
| 8 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS percent of total billed charges · bothfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 9 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CANTON, MS other · both | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 10 | St. Charles Madras Madras, OR percent of total billed charges · bothfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 11 | Stephens County Hospital Toccoa, GA fee schedule · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 12 | ThedaCare Regional Medical Center-Berlin Inc WI 54971-9286; N2930 State Rd 22 Wautoma, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 13 | Thedacare Regional Medical Center-New London Inc WI 54961; 370 S. Main St. Clintonville, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 14 | Thedacare Regional Medical Center-Shawano Inc Shawano, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 15 | Thedacare Regional Medical Center-Waupaca Inc Waupaca, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 16 | Thedacare Regional Medical Center-Wild Rose Inc Wild Rose, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
← Payers reporting CPT 90655 · Snapshot 20261113T090226Z-3ce6c0b8