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
$6
Average
$104
Median
$43
High
$15.9k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
309 hospitals; the 90th percentile is 4.9× 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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387 hospital rates
iThe hospitals that file a Molina 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 | Nor-Lea Hospital District Lovington, NM facility · fee schedule · both | 1 | $40 | $40 | — | — | 4–40 | $40 – $40 |
| 2 | Nor-Lea Hospital District Lovington, NM professional · fee schedule · both | 1 | $35 | $35 | — | — | 4–40 | $35 – $35 |
| 3 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient | 2 | $54 | $54 | $5 | 10% | 1–10 | $49 – $59 |
| 4 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient | 2 | $54 | $54 | $5 | 10% | 1–10 | $49 – $59 |
| 5 | Pocatello Hospital, LLC Pocatello, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $48 | $48 | — | — | 1–10 | $48 – $48 |
| 6 | AHS Henryetta Hospital, LLC Henryetta, OK facility · percent of total billed charges · bothfrom % of charges | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 7 | AHS Pryor Hospital, LLC Pryor, OK facility · percent of total billed charges · bothfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 8 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 9 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 10 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $101 | $101 | — | — | — | $101 – $101 |
| 11 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $10 | $10 | $1 | 14% | — | $9 – $12 |
| 12 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $75 | $75 | $26 | 34% | — | $50 – $101 |
| 13 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 14 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 15 | Advocate Christ Medical Center Oak Lawn, IL facility · case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 16 | Advocate Condell Medical Center Libertyville, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 17 | Advocate Good Samaritan Hospital Downers Grove, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 18 | Advocate Good Shepherd Hospital Barrington, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 19 | Advocate Illinois Masonic Medical Center Chicago, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 20 | Advocate Lutheran General Hospital Park Ridge, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 21 | Advocate Sherman Hospital Elgin, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 22 | Advocate South Suburban Hospital Hazel Crest, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 23 | Advocate Trinity Hospital Chicago, IL case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 24 | Aiken Regional Medical Centers North Augusta, SC fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 25 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
← Payers reporting CPT 90661 · Snapshot 20261111T120946Z-9134e7f7