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
$17
Median
$10
High
$211
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30 hospital rates
iThe hospitals that file a WellCare 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 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 2 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 3 | BRONXCARE HEALTH SYSTEM Bronx, NY other · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 4 | BRONXCARE HEALTH SYSTEM Bronx, NY other · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 5 | COCHRAN MEMORIAL HOSPITAL MORTON, TX other · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 4 | $0 | $2 | $5 | 330% | — | $0 – $18 |
| 8 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 4 | $0 | $2 | $5 | 330% | — | $0 – $18 |
| 9 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $0 | $2 | $5 | 330% | — | $0 – $18 |
| 10 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 2 | $0 | $5 | $8 | 173% | — | $0 – $18 |
| 11 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | Gadsden Regional Medical Center LLC Gadsden, AL facility · fee schedule · outpatient | 2 | $19 | $19 | $4 | 19% | — | $15 – $23 |
| 15 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 16 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 17 | Jennie Stuart Medical Center Hopkinsville, KY professional · fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 18 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 19 | OCHSNER MEDICAL CENTER � HANCOCK LLC Bay St. Louis, MS other · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 20 | Ochsner American Legion Hospital, LLC Jennings, LA other · outpatient | 1 | $198 | $211 | $58 | 28% | — | $152 – $294 |
| 21 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 22 | Penn Medicine Princeton Medical Center Princeton, NJ facility · other · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 23 | Piedmont Columbus Regional - Midtown Columbus, GA percent of total billed charges · bothfrom % of charges | 2 | $5 | $5 | — | — | — | $5 – $5 |
| 24 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS percent of total billed charges · bothfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 25 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CANTON, MS other · both | 1 | $16 | $16 | — | — | — | $16 – $16 |
← Payers reporting CPT 90655 · Snapshot 20261113T090226Z-3ce6c0b8