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 Influenza Trivalent (Riv3) Rdna Antibiotic/Preservative Free Im
Low
$0
Average
$126
Median
$98
High
$3.7k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
261 hospitals; the 90th percentile is 3.9× 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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439 hospital rates
iThe hospitals that file a Anthem 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 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $137 | — | — | 507–597 | $137 – $137 |
| 2 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $137 | — | — | 269–323 | $137 – $137 |
| 3 | University of Virginia Medical Center Charlottesville, VA percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | 267 | $17 – $17 |
| 4 | Spooner Health System, Inc Spooner, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $62 | $62 | — | — | 43 | $62 – $62 |
| 5 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 2 | $86 | $90 | $5 | 5% | 6–60 | $86 – $96 |
| 6 | Samaritan Hospital Troy, NY professional · percent of total billed charges · inpatientfrom % of charges | 1 | $161 | $161 | — | — | 2–20 | $161 – $161 |
| 7 | University of Virginia Culpeper Medical Center Culpeper, VA percent of total billed charges · bothfrom % of charges | 1 | $19 | $19 | $3 | 14% | 2–20 | $16 – $22 |
| 8 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 9 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 2 | $192 | $192 | $16 | 8% | — | $176 – $207 |
| 10 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 11 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 12 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $93 | $93 | $12 | 12% | — | $82 – $105 |
| 13 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 2 | $98 | $90 | $11 | 12% | — | $75 – $98 |
| 14 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 3 | $60 | $56 | $9 | 16% | — | $44 – $65 |
| 16 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 17 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 4 | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 18 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 19 | Adena Health System Chillicothe, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 20 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 21 | Ascension SE Wisconsin Hospital, Inc. Milwaukee, WI other · outpatient | 3 | $138 | $160 | $41 | 26% | — | $124 – $217 |
| 22 | Ascension SE Wisconsin Hospital, Inc. Franklin, WI other · outpatient | 3 | $138 | $160 | $41 | 26% | — | $124 – $217 |
| 23 | Ascension SE Wisconsin Hospital, Inc. Brookfield, WI other · outpatient | 3 | $138 | $160 | $41 | 26% | — | $124 – $217 |
| 24 | Ascension St. Francis Hospital, Inc. Milwaukee, WI other · outpatient | 3 | $138 | $160 | $41 | 26% | — | $124 – $217 |
| 25 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · both | 3 | $39 | $39 | — | — | — | $39 – $39 |
← Payers reporting CPT 90673 · Snapshot 20261111T120946Z-9134e7f7