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
$2
Average
$62
Median
$50
High
$2.1k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
177 hospitals; the 90th percentile is 4.7× 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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197 hospital rates
iThe hospitals that file a WellCare 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 | Brunswick Community Hospital, LLC Bolivia, NC percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | 1–10 | $18 – $18 |
| 2 | Forsyth Memorial Hospital, Inc. Winston-Salem, NC percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | — | — | 1–10 | $21 – $21 |
| 3 | Piedmont Columbus Regional - Midtown Columbus, GA percent of total billed charges · bothfrom % of charges | 2 | $2 | $2 | — | — | 1–10 | $2 – $2 |
| 4 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 2 | $10 | $10 | $2 | 19% | 1–10 | $8 – $12 |
| 5 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | 1–10 | $63 – $63 |
| 6 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | 1–10 | $63 – $63 |
| 7 | UNIVERSITY OF TEXAS HEALTH CENTER AT TYLER Tyler, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $62 | $62 | — | — | 1–10 | $62 – $62 |
| 8 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $102 | $102 | — | — | — | $102 – $102 |
| 9 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $53 | $53 | $1 | 2% | — | $52 – $54 |
| 10 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 11 | Aiken Regional Medical Centers North Augusta, SC fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 12 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 13 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 14 | Athens Hospital, LLC Athens, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 15 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 16 | BETHESDA HOSPITAL BOYNTON BEACH, FL fee schedule · both | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 17 | Benefis Hospitals Inc Helena, MT percent of total billed charges · outpatientfrom % of charges | 1 | $34 | $34 | $16 | 48% | — | $18 – $51 |
| 18 | Benefis Senior Services Great Falls, MT percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 19 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 20 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 21 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 22 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 23 | Carle Eureka Hospital Eureka, IL case rate · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 24 | Carthage Hospital, LLC Carthage, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 25 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $79 | $79 | — | — | — | $79 – $79 |
← Payers reporting CPT 90661 · Snapshot 20261111T120946Z-9134e7f7