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
PR LAIV3 VACCINE LIVE FOR INTRANASAL USE
Low
$0
Average
$28
Median
$27
High
$137
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
43 hospitals; the 90th percentile is 2.1× 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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44 hospital rates
iThe hospitals that file a Tricare 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 fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 2 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $29 | $29 | — | — | — | $29 – $29 |
| 3 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 4 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 5 | Bluffton Health System LLC Bluffton, IN facility · fee schedule · outpatient | 1 | $28 | $21 | $12 | 58% | — | $0 – $28 |
| 6 | Brandon HMA LLC Brandon, MS facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY professional · fee schedule · outpatient | 4 | $29 | $29 | — | — | — | $29 – $29 |
| 8 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 9 | Dupont Hospital LLC Wayne, IN facility · fee schedule · outpatient | 1 | $14 | $14 | $14 | 100% | — | $0 – $28 |
| 10 | Durant HMA LLC Durant, OK facility · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 11 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $27 | $27 | $2 | 8% | — | $25 – $30 |
| 12 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 13 | HMA Santa Rosa Medical Center LLC Milton, FL facility · fee schedule · outpatient | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 14 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 15 | IOM Health System LP Fort Wayne, IN facility · fee schedule · outpatient | 1 | $14 | $14 | $14 | 100% | — | $0 – $28 |
| 16 | Jackson HMA LLC Jackson, MS facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Kaweah Health Rehabilitation Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 18 | Knox Hospital Company LLC Knox, IN facility · fee schedule · outpatient | 1 | $14 | $14 | $14 | 100% | — | $0 – $28 |
| 19 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 20 | La Porte Hospital Company LLC La Porte, IN facility · fee schedule · outpatient | 1 | $14 | $14 | $14 | 100% | — | $0 – $28 |
| 21 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 22 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · fee schedule · outpatient | 1 | $14 | $14 | $14 | 100% | — | $0 – $28 |
| 23 | Massena Hospital Inc Massena, NY facility · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 24 | Mat-Su Valley Medical Center LLC Palmer, AK facility · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 25 | Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
← Payers reporting CPT 90660 · Snapshot 20261112T181611Z-3fa9fb76