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
$22
Average
$68
Median
$60
High
$154
Each hospital's average Magellan rate, under the methodology and billing class chosen below.
17 hospitals; the 90th percentile is 3.3× 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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19 hospital rates
iThe hospitals that file a Magellan 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 | Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 2 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $154 | $154 | — | — | — | $154 – $154 |
| 3 | Lake Charles Memorial Hospital Charles., LA percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 4 | Lovelace Health System, LLC Albuquerque, NM facility · percent of total billed charges · bothfrom % of charges | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 5 | Lovelace Health System, LLC Albuquerque, NM facility · percent of total billed charges · bothfrom % of charges | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 6 | Lovelace Health System, LLC Roswell, NM facility · percent of total billed charges · bothfrom % of charges | 1 | $117 | $117 | — | — | — | $117 – $117 |
| 7 | Lovelace UNM Rehabilition Hospital, LLC Albuquerque, NM facility · percent of total billed charges · bothfrom % of charges | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 8 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 9 | Morristown Medical Center Morristown, NJ percent of total billed charges · bothfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 10 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 11 | Pocatello Hospital, LLC Pocatello, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 12 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 13 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 14 | Samaritan Hospital Troy, NY professional · percent of total billed charges · inpatientfrom % of charges | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 15 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 16 | St Peters Hospital Albany, NY professional · percent of total billed charges · inpatientfrom % of charges | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 17 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 18 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 19 | Yale New Haven Hospital Haven, CT fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
← Payers reporting CPT 90661 · Snapshot 20261111T120946Z-9134e7f7