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 vaccine splt 0.5 ml im
Low
$4
Average
$57
Median
$27
High
$10.8k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
1004 hospitals; the 90th percentile is 3.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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1,374 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $20 | $20 | — | — | 1–10 | $20 – $20 |
| 2 | Eastern Maine Medical Center Bangor, ME facility · percent of total billed charges · outpatientfrom % of charges | 1 | $29 | $29 | — | — | 1–10 | $29 – $29 |
| 3 | Lake Charles Memorial Hospital Charles., LA other · outpatient | 1 | $20 | $20 | — | — | 1–10 | $20 – $20 |
| 4 | Mercy Hospital Portland, ME facility · percent of total billed charges · outpatientfrom % of charges | 1 | $29 | $29 | — | — | 1–10 | $29 – $29 |
| 5 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 3 | $23 | $29 | $10 | 35% | 1–10 | $22 – $44 |
| 6 | OU Health - University of Oklahoma Medical Center Edmond, OK facility · other · outpatient | 1 | $7 | $7 | — | — | 1–10 | $7 – $7 |
| 7 | Tanner Medical Center - Villa Rica Villa Rica, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $40 | $40 | — | — | 1–10 | $40 – $40 |
| 8 | The Aroostook Medical Center Isle, ME facility · percent of total billed charges · outpatientfrom % of charges | 1 | $29 | $29 | — | — | 1–10 | $29 – $29 |
| 9 | Tufts Medical Center BOSTON, MA other · both | 1 | $142 | $142 | — | — | 1–10 | $142 – $142 |
| 10 | Virginia Mason Medical Center Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $16 | $16 | — | — | 1–10 | $16 – $16 |
| 11 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 2 | $24 | $24 | — | — | — | $24 – $24 |
| 12 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 2 | $24 | $24 | — | — | — | $24 – $24 |
| 13 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 14 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 15 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · fee schedule · outpatient | 3 | $26 | $26 | $2 | 8% | — | $23 – $28 |
| 16 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 17 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 18 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 8 | $23 | $23 | $1 | 3% | — | $22 – $23 |
| 19 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 3 | $24 | $24 | $1 | 3% | — | $23 – $24 |
| 20 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 3 | $24 | $24 | $1 | 3% | — | $23 – $24 |
| 21 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $25 | $25 | $0 | 1% | — | $25 – $25 |
| 22 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 2 | $29 | $29 | $6 | 21% | — | $23 – $35 |
| 23 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 24 | AdventHealth Avista Louisville, CO fee schedule · outpatient | 4 | $36 | $36 | — | — | — | $36 – $36 |
| 25 | AdventHealth Castle Rock Castle Rock, CO fee schedule · outpatient | 4 | $36 | $36 | — | — | — | $36 – $36 |
← Payers reporting CPT 90658 · Snapshot 20261112T181611Z-3fa9fb76