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
$85
Median
$56
High
$260
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161 hospital rates
iThe hospitals that file a MultiPlan 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 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $26 | $0 | 0% | — | $26 – $26 |
| 2 | Alta Newport Hospital, LLC Tustin, CA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 3 | Alta Newport Hospital, LLC Tustin, CA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 4 | Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · both | 2 | $42 | $42 | $1 | 3% | — | $41 – $43 |
| 5 | Aspirus Wausau Hospital Wausau, WI fee schedule · both | 2 | $42 | $42 | $1 | 3% | — | $41 – $43 |
| 6 | Bexar County Hospital District San Antonio, TX percent of total billed charges · inpatientfrom % of charges | 2 | $42 | $42 | $2 | 4% | — | $41 – $44 |
| 7 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 2 | $42 | $42 | $2 | 4% | — | $41 – $44 |
| 8 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 9 | Bronson Battle Creek Hospital Battle Creek, MI professional · fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 10 | CENTENNIAL HOSPITAL A CAMPUS OF TMCA ENGLEWOOD, CO percent of total billed charges · outpatientfrom % of charges | 3 | $41 | $40 | $4 | 10% | — | $34 – $44 |
| 11 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · fee schedule · inpatient | 1 | $62 | $62 | $1 | 2% | — | $61 – $64 |
| 12 | Centennial Hills Las Vegas, NV percent of total billed charges · bothfrom % of charges | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 13 | Connecticut Children's Hartford, CT percent of total billed charges · bothfrom % of charges | 2 | $18 | $17 | $1 | 7% | — | $15 – $18 |
| 14 | Corona Regional Medical Center Corona, CA percent of total billed charges · bothfrom % of charges | 1 | $167 | $167 | — | — | — | $167 – $167 |
| 15 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 16 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 17 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 1 | $0 | $0 | $0 | 97% | — | $0 – $1 |
| 18 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | $0 | 97% | — | $0 – $1 |
| 19 | Deaconess Illinois Red Bud Regional Hospital Inc Red Bud, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $10 | $10 | $8 | 80% | — | $2 – $20 |
| 20 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · inpatient | 1 | $62 | $62 | $1 | 2% | — | $61 – $64 |
| 21 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 22 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 23 | Fairview Health Services Edina, MN percent of total billed charges · inpatientfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 24 | Fairview Health Services Edina, MN percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 25 | Fairview Health Services Minneapolis, MN percent of total billed charges · inpatientfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
← Payers reporting CPT 90655 · Snapshot 20261113T090226Z-3ce6c0b8