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 Vaccine Cciiv3 Derived Frm Cell Culture Subunit Antibiotic Free 0.5ml Im
Low
$0
Average
$135
Median
$73
High
$3.3k
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
145 hospitals; the 90th percentile is 13.7× 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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170 hospital rates
iThe hospitals that file a Ambetter 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 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient | 1 | $50 | $50 | — | — | 13 | $50 – $50 |
| 2 | Piedmont Athens Regional Athens, GA percent of total billed charges · bothfrom % of charges | 1 | $30 | $30 | $26 | 87% | 2–20 | $4 – $55 |
| 3 | Piedmont Augusta Augusta, GA percent of total billed charges · bothfrom % of charges | 1 | $55 | $55 | $48 | 87% | 2–20 | $7 – $103 |
| 4 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 5 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient | 1 | $50 | $50 | — | — | 1–10 | $50 – $50 |
| 6 | Morton Plant Hospital Clearwater, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 7 | Piedmont Columbus Regional - Midtown Columbus, GA percent of total billed charges · bothfrom % of charges | 1 | $5 | $5 | — | — | 1–10 | $5 – $5 |
| 8 | Piedmont Eastside Snellville, GA percent of total billed charges · bothfrom % of charges | 1 | $42 | $42 | — | — | 1–10 | $42 – $42 |
| 9 | St. Joseph's Hospital Tampa, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 10 | The University of Kansas Health System- St. Francis Campus Topeka, KS facility · percent of total billed charges · bothfrom % of charges | 1 | $118 | $118 | — | — | 1–10 | $118 – $118 |
| 11 | Winter Haven Hospital Haven, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 12 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 13 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 14 | Advocate Christ Medical Center Oak Lawn, IL facility · case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 15 | Advocate Condell Medical Center Libertyville, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 16 | Advocate Good Samaritan Hospital Downers Grove, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 17 | Advocate Good Shepherd Hospital Barrington, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 18 | Advocate Illinois Masonic Medical Center Chicago, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 19 | Advocate Lutheran General Hospital Park Ridge, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 20 | Advocate Sherman Hospital Elgin, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 21 | Advocate South Suburban Hospital Hazel Crest, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 22 | Advocate Trinity Hospital Chicago, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 23 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 24 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · both | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 25 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $597 | $597 | — | — | — | $597 – $597 |
← Payers reporting CPT 90661 · Snapshot 20261111T120946Z-9134e7f7