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
$9
Average
$125
Median
$45
High
$2.4k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
141 hospitals; the 90th percentile is 13.3× 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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223 hospital rates
iThe hospitals that file a Medica 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 | Westfields Hospital New Richmond, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $48 | $48 | $14 | 29% | 82 | $34 – $62 |
| 2 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · percent of total billed charges · outpatientfrom % of charges | 6 | $58 | $53 | $12 | 23% | 3–30 | $28 – $67 |
| 3 | Essentia Health St. Joseph's Medical Center Brainerd, MN facility · percent of total billed charges · outpatientfrom % of charges | 6 | $67 | $58 | $15 | 26% | 3–30 | $33 – $76 |
| 4 | Essentia Health St. Mary's - Detroit Lakes 1027 Washington Ave. Detroit Lakes, MN facility · percent of total billed charges · outpatientfrom % of charges | 5 | $70 | $65 | $16 | 25% | 3–30 | $45 – $84 |
| 5 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 5 | $52 | $51 | $9 | 19% | 3–30 | $35 – $64 |
| 6 | Essentia Health St. Mary's Medical Center Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 5 | $52 | $51 | $9 | 19% | 3–30 | $35 – $64 |
| 7 | Essentia Health Virginia 901 9th St N Virginia, MN facility · percent of total billed charges · outpatientfrom % of charges | 6 | $67 | $57 | $17 | 30% | 3–30 | $24 – $77 |
| 8 | Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges | 3 | $19 | $30 | $17 | 57% | 2–20 | $16 – $54 |
| 9 | Avera Sacred Heart Hospital Yankton, SD fee schedule · outpatient | 2 | $125 | $125 | — | — | 1–10 | $125 – $125 |
| 10 | AHS Claremore Hospital, LLC Claremore, OK facility · percent of total billed charges · bothfrom % of charges | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 11 | AHS Pryor Hospital, LLC Pryor, OK facility · percent of total billed charges · bothfrom % of charges | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 12 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · inpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 13 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 5 | $45 | $36 | $14 | 40% | — | $15 – $51 |
| 14 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · inpatient | 4 | $42 | $42 | $1 | 3% | — | $41 – $43 |
| 15 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · outpatient | 5 | $41 | $39 | $6 | 15% | — | $27 – $43 |
| 16 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · inpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 17 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 5 | $45 | $36 | $16 | 44% | — | $11 – $51 |
| 18 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 4 | $42 | $42 | $1 | 3% | — | $41 – $43 |
| 19 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · outpatient | 5 | $41 | $38 | $9 | 24% | — | $19 – $43 |
| 20 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · inpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 21 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 5 | $45 | $35 | $16 | 46% | — | $9 – $51 |
| 22 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · inpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 23 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 24 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · inpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 25 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 5 | $45 | $35 | $16 | 46% | — | $9 – $51 |
← Payers reporting CPT 90661 · Snapshot 20261111T120946Z-9134e7f7