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
$10
Average
$118
Median
$92
High
$545
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
47 hospitals; the 90th percentile is 11.1× 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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53 hospital rates
iThe hospitals that file a Medicaid 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 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $209 | $209 | — | — | — | $209 – $209 |
| 2 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $209 | $209 | — | — | — | $209 – $209 |
| 3 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 4 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 5 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 6 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 7 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 8 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 9 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 10 | Fairview Hospital Great Barrington, MA facility · fee schedule · outpatient | 2 | $48 | $48 | — | — | — | $48 – $48 |
| 11 | Greater Baltimore Medical Center Towson, MD professional · fee schedule · both | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 12 | HMA Santa Rosa Medical Center LLC Milton, FL facility · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 13 | Hackettstown Medical Center Hackettstown, NJ percent of total billed charges · bothfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 14 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · other · outpatient | 1 | $101 | $101 | — | — | — | $101 – $101 |
| 15 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 16 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $209 | $209 | — | — | — | $209 – $209 |
| 17 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $545 | $545 | — | — | — | $545 – $545 |
| 18 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $545 | $545 | — | — | — | $545 – $545 |
| 19 | MINDEN MEDICAL CENTER MINDEN, LA percent of total billed charges · bothfrom % of charges | 16 | $92 | $92 | — | — | — | $92 – $92 |
| 20 | McLeod Health Dillon, SC fee schedule · both | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 21 | McLeod Health Cheraw, SC fee schedule · both | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 22 | McLeod Health Manning, SC fee schedule · both | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 23 | McLeod Health Florence, SC fee schedule · both | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 24 | McLeod Health Beach, SC fee schedule · both | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 25 | McLeod Health Loris, SC fee schedule · both | 1 | $133 | $133 | — | — | — | $133 – $133 |
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