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
$118
Median
$72
High
$1.1k
Each hospital's average First Health rate, under the methodology and billing class chosen below.
207 hospitals; the 90th percentile is 11.4× 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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328 hospital rates
iThe hospitals that file a First Health 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 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA percent of total billed charges · outpatientfrom % of charges | 1 | $54 | $54 | $20 | 36% | — | $34 – $74 |
| 2 | AHS Henryetta Hospital, LLC Henryetta, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $169 | $169 | $20 | 12% | — | $149 – $189 |
| 3 | AHS Pryor Hospital, LLC Pryor, OK facility · percent of total billed charges · bothfrom % of charges | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 4 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 5 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $20 | $20 | $3 | 14% | — | $17 – $23 |
| 6 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 7 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $20 | $20 | $3 | 14% | — | $17 – $23 |
| 8 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 9 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 10 | Allina Health Systems Owatonna, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 11 | Allina Health Systems Owatonna, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 12 | Allina Health Systems Ulm, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 13 | Allina Health Systems Ulm, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 14 | Allina Health Systems Cambridge, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 15 | Allina Health Systems Cambridge, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 16 | Allina Health Systems Faribualt, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 17 | Allina Health Systems Faribualt, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 18 | Allina Health Systems River Falls, WI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 19 | Allina Health Systems River Falls, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 20 | Allina Health Systems Buffalo, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 21 | Allina Health Systems Buffalo, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 22 | Amery Hospital Amery, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 23 | BRFHH MONROE, LLC Monroe, LA other · inpatient | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 24 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 25 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 1 | $131 | $131 | $63 | 48% | — | $68 – $194 |
← Payers reporting CPT 90661 · Snapshot 20261111T120946Z-9134e7f7