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
$64
Median
$50
High
$3.6k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
296 hospitals; the 90th percentile is 3.5× 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.
Filter by billing methodology
Filter by billing class
450 hospital rates
iThe hospitals that file a Anthem 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 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | 149–221 | $63 – $63 |
| 2 | NATIONAL JEWISH HEALTH GOLDEN, CO percent of total billed charges · bothfrom % of charges | 1 | $41 | $41 | $13 | 32% | 98 | $28 – $54 |
| 3 | Eskenazi Health Indianapolis, IN facility · other · outpatient | 2 | $140 | $140 | — | — | 27–36 | $140 – $140 |
| 4 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | 22–31 | $63 – $63 |
| 5 | Eskenazi Health Indianapolis, IN facility · fee schedule · outpatient | 1 | $36 | $36 | — | — | 18 | $36 – $36 |
| 6 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient | 2 | $69 | $61 | $10 | 17% | 2–20 | $49 – $69 |
| 7 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient | 2 | $69 | $61 | $10 | 17% | 2–20 | $49 – $69 |
| 8 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | — | — | 1–10 | $42 – $42 |
| 9 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 10 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 2 | $97 | $97 | $8 | 8% | — | $89 – $104 |
| 11 | ALICE_PECK_DAY_MEMORIAL_HOSPITAL LEBANON, NH percent of total billed charges · outpatientfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 12 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $41 | $41 | $5 | 12% | — | $36 – $46 |
| 13 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 2 | $50 | $44 | $8 | 17% | — | $33 – $50 |
| 14 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 3 | $14 | $14 | $3 | 21% | — | $10 – $19 |
| 16 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $7 | $7 | $1 | 14% | — | $6 – $8 |
| 17 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 4 | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 18 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $16 | $16 | $2 | 14% | — | $14 – $18 |
| 19 | Adena Health System Chillicothe, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $16 | $16 | $2 | 14% | — | $14 – $18 |
| 20 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 21 | Appalachian Regional Healthcare, Inc. Hazard, KY fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 22 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 23 | Ascension SE Wisconsin Hospital, Inc. Milwaukee, WI other · outpatient | 3 | $61 | $71 | $18 | 26% | — | $55 – $96 |
| 24 | Ascension SE Wisconsin Hospital, Inc. Franklin, WI other · outpatient | 3 | $61 | $71 | $18 | 26% | — | $55 – $96 |
| 25 | Ascension SE Wisconsin Hospital, Inc. Brookfield, WI other · outpatient | 3 | $61 | $71 | $18 | 26% | — | $55 – $96 |
← Payers reporting CPT 90661 · Snapshot 20261111T120946Z-9134e7f7