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
$32
Median
$19
High
$85
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21 hospital rates
iThe hospitals that file a Phcs 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 | Alta Newport Hospital, LLC Tustin, CA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 2 | Alta Newport Hospital, LLC Tustin, CA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 3 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 4 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $14 | $14 | $6 | 44% | — | $8 – $20 |
| 5 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 6 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · fee schedule · inpatient | 1 | $62 | $62 | $1 | 2% | — | $61 – $64 |
| 7 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 1 | $0 | $0 | $0 | 97% | — | $0 – $1 |
| 8 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | $0 | 97% | — | $0 – $1 |
| 9 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · inpatient | 1 | $62 | $62 | $1 | 2% | — | $61 – $64 |
| 10 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 11 | Jasper Health Services Monticello, GA percent of total billed charges · inpatientfrom % of charges | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 12 | Jasper Health Services Monticello, GA percent of total billed charges · outpatientfrom % of charges | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 13 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 14 | Piedmont Athens Regional Athens, GA percent of total billed charges · bothfrom % of charges | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 15 | Piedmont Augusta Augusta, GA percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 16 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS percent of total billed charges · bothfrom % of charges | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 17 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 18 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 19 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 20 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 21 | WHITE MEMORIAL MEDICAL CENTER MONTEBELLO, CA percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $60 | — | — | — | $60 – $60 |
← Payers reporting CPT 90655 · Snapshot 20261113T090226Z-3ce6c0b8