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
$1
Average
$35
Median
$22
High
$2.0k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
163 hospitals; the 90th percentile is 2.6× 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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181 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 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $24 | $24 | $1 | 2% | — | $23 – $24 |
| 2 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 3 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 2 | $16 | $16 | $3 | 19% | — | $13 – $19 |
| 4 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 5 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 6 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 2 | $23 | $22 | $1 | 6% | — | $20 – $23 |
| 7 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 8 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 9 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 10 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 11 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 12 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 13 | COCHRAN MEMORIAL HOSPITAL MORTON, TX other · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 14 | Calais Community Hospital Calais, ME percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 15 | Calhoun Liberty Hospital Association Inc Blountstown, FL other · both | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 16 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 17 | Carle Eureka Hospital Eureka, IL case rate · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 18 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 19 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 20 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 21 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 22 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $83 | $83 | — | — | — | $83 – $83 |
| 23 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 24 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 25 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $83 | $83 | — | — | — | $83 – $83 |
← Payers reporting CPT 90658 · Snapshot 20261112T181611Z-3fa9fb76