Pneumococcal conjugate vaccine (15-valent) injection

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Pcv15 Vaccine for Intramuscular Use

Payers reporting CPT 90671

Payer pricing summary

Low

$63

Average

$392

Median

$324

High

$1.0k

Payer rate distribution

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#
1	Bcbs Al facility · other · outpatient · +2 other terms	3	$161	$165	$18	11%	1–10	$145 – $189
2	UnitedHealthcare fee schedule · outpatient · +28 other terms	535	$431	$426	$204	48%	—	$0 – $1.6k
3	Cigna fee schedule · outpatient · +21 other terms	271	$385	$688	$521	76%	—	$0 – $2.4k
4	Blue Cross Blue Shield fee schedule · outpatient · +25 other terms	239	$470	$629	$377	60%	—	$0 – $1.7k
5	Humana fee schedule · outpatient · +22 other terms	189	$256	$287	$145	50%	—	$0 – $962
6	Aetna fee schedule · outpatient · +28 other terms	172	$270	$519	$770	148%	—	$0 – $8.4k
7	Anthem fee schedule · outpatient · +18 other terms	106	$287	$343	$207	60%	—	$226 – $1.8k
8	Caresource fee schedule · outpatient · +14 other terms	64	$273	$282	$74	26%	—	$133 – $444
9	Molina fee schedule · outpatient · +20 other terms	55	$272	$354	$202	57%	—	$10 – $619
10	Tricare facility · fee schedule · outpatient · +12 other terms	55	$248	$199	$109	55%	—	$0 – $387
11	WellCare facility · fee schedule · outpatient · +18 other terms	46	$241	$197	$83	42%	—	$2 – $334
12	Devoted facility · fee schedule · outpatient · +8 other terms	38	$269	$358	$312	87%	—	$51 – $2.2k
13	Kaiser fee schedule · outpatient · +14 other terms	35	$256	$280	$116	41%	—	$137 – $634
14	Bcbs Tx fee schedule · outpatient · +2 other terms	28	$1.1k	$1.0k	$312	31%	—	$123 – $1.7k
15	Ambetter facility · fee schedule · outpatient · +15 other terms	27	$485	$517	$565	109%	—	$2 – $3.3k
16	Medica fee schedule · outpatient · +12 other terms	27	$16	$310	$261	84%	—	$16 – $664
17	Medicare fee schedule · outpatient · +8 other terms	23	$256	$232	$43	18%	—	$129 – $264
18	Aetna Better Health fee schedule · outpatient · +9 other terms	22	$261	$273	$14	5%	—	$261 – $298
19	Medcost percent of total billed charges · outpatientfrom % of charges · +5 other terms	22	$411	$604	$394	65%	—	$168 – $1.7k
20	Medicaid fee schedule · both · +9 other terms	22	$268	$232	$108	47%	—	$76 – $417
21	Regence professional · fee schedule · outpatient · +8 other terms	22	$246	$251	$15	6%	—	$246 – $317
22	Wellmark fee schedule · outpatient · +10 other terms	22	$261	$261	—	—	—	$261 – $261
23	Optum facility · per diem · outpatient · +16 other terms	21	$329	$398	$140	35%	—	$153 – $583
24	Highmark fee schedule · outpatient · +12 other terms	20	$286	$292	$80	27%	—	$14 – $325
25	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +2 other terms	18	$444	$444	$88	20%	—	$331 – $606

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