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
$13
Average
$57
Median
$19
High
$763
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26 hospital rates
iThe hospitals that file a Regence 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 | ALBANY GENERAL HOSPITAL Albany, OR facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 2 | CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT fee schedule · outpatient | 4 | $14 | $13 | $2 | 14% | — | $10 – $15 |
| 3 | CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT fee schedule · outpatient | 4 | $14 | $13 | $2 | 14% | — | $10 – $15 |
| 4 | CATHOLIC HEALTH INITIATIVES COLORADO Lehi, UT fee schedule · outpatient | 4 | $14 | $13 | $2 | 14% | — | $10 – $15 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Layton, UT fee schedule · outpatient | 4 | $14 | $13 | $2 | 14% | — | $10 – $15 |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 4 | $14 | $13 | $2 | 14% | — | $10 – $15 |
| 7 | GOOD SAMARITAN HOSPITAL CORVALLIS Corvallis, OR facility · fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 8 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 9 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 10 | MID COLUMBIA MEDICAL CENTER Dalles, OR percent of total billed charges · outpatientfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 11 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 12 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 13 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 4 | $14 | $15 | $1 | 6% | — | $14 – $16 |
| 14 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 4 | $17 | $16 | $1 | 4% | — | $15 – $17 |
| 15 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 4 | $14 | $15 | $1 | 6% | — | $14 – $16 |
| 16 | MultiCare Valley Hospital Spokane Valley, WA fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 17 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA fee schedule · outpatient | 4 | $19 | $19 | $1 | 4% | — | $18 – $19 |
| 18 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 19 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · fee schedule · both | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 20 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 21 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 22 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 23 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 24 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 25 | St. Charles Madras Madras, OR fee schedule · both | 1 | $46 | $46 | — | — | — | $46 – $46 |
← Payers reporting CPT 90655 · Snapshot 20261113T090226Z-3ce6c0b8