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 Pneumococcal Conjugate 20 Valent (Pcv20) Im
Low
$74
Average
$536
Median
$423
High
$4.0k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
456 hospitals; the 90th percentile is 3.6× 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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897 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 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 6 | $310 | $305 | $8 | 2% | 1,282–1,336 | $288 – $310 |
| 2 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $596 | $596 | — | — | 484–574 | $596 – $596 |
| 3 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $400 | $400 | — | — | 424–505 | $400 – $400 |
| 4 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 2 | $299 | $302 | $4 | 1% | 338–374 | $299 – $307 |
| 5 | Mary Hitchcock Memorial Hospital Lebanon, NH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $331 | $331 | — | — | 337 | $331 – $331 |
| 6 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $400 | $400 | — | — | 310–364 | $400 – $400 |
| 7 | Cheshire Medical Center Keene, NH facility · percent of total billed charges · outpatientfrom % of charges | 2 | $190 | $190 | $137 | 72% | 166–175 | $53 – $327 |
| 8 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · outpatientfrom % of charges | 5 | $663 | $677 | $42 | 6% | 164 | $639 – $748 |
| 9 | Eastern Maine Medical Center Bangor, ME facility · percent of total billed charges · outpatientfrom % of charges | 3 | $296 | $298 | $4 | 1% | 156 | $296 – $307 |
| 10 | University of Virginia Medical Center Charlottesville, VA percent of total billed charges · bothfrom % of charges | 1 | $113 | $113 | — | — | 125 | $113 – $113 |
| 11 | University of Virginia Medical Center Charlottesville, VA percent of total billed charges · outpatientfrom % of charges | 1 | $96 | $96 | — | — | 125 | $96 – $96 |
| 12 | University Medical Center, Inc. Louisville, KY facility · percent of total billed charges · outpatientfrom % of charges | 5 | $569 | $873 | $1.0k | 116% | 91 | $110 – $3.2k |
| 13 | UofL Health -Shelbyville, Inc. Shelbyville, KY facility · percent of total billed charges · outpatientfrom % of charges | 4 | $569 | $564 | $20 | 4% | 91 | $529 – $587 |
| 14 | UofL Health-Louisville Inc. Louisville, KY facility · percent of total billed charges · outpatientfrom % of charges | 4 | $569 | $564 | $20 | 4% | 91 | $529 – $587 |
| 15 | UofL Health-Louisville Inc. Louisville, KY facility · percent of total billed charges · outpatientfrom % of charges | 4 | $569 | $564 | $20 | 4% | 91 | $529 – $587 |
| 16 | UofL Health-Louisville Inc. Louisville, KY facility · percent of total billed charges · outpatientfrom % of charges | 4 | $569 | $564 | $20 | 4% | 91 | $529 – $587 |
| 17 | UofL Health-Louisville Inc. Shepherdville, KY facility · percent of total billed charges · outpatientfrom % of charges | 4 | $569 | $564 | $20 | 4% | 91 | $529 – $587 |
| 18 | UofL Health-Louisville Inc. Louisville, KY facility · percent of total billed charges · outpatientfrom % of charges | 4 | $569 | $564 | $20 | 4% | 91 | $529 – $587 |
| 19 | UofL Health-Louisville Inc. Louisville, KY facility · percent of total billed charges · outpatientfrom % of charges | 4 | $569 | $564 | $20 | 4% | 91 | $529 – $587 |
| 20 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 3 | $313 | $304 | $17 | 6% | 86–149 | $257 – $313 |
| 21 | Mercy Hospital Portland, ME facility · percent of total billed charges · outpatientfrom % of charges | 3 | $296 | $297 | $2 | 1% | 58 | $296 – $302 |
| 22 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $596 | $596 | — | — | 52–70 | $596 – $596 |
| 23 | NATIONAL JEWISH HEALTH GOLDEN, CO percent of total billed charges · bothfrom % of charges | 1 | $339 | $339 | — | — | 49 | $339 – $339 |
| 24 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $839 | $821 | $275 | 34% | 48 | $500 – $1.1k |
| 25 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 2 | $299 | $302 | $4 | 1% | 34–106 | $299 – $307 |
← Payers reporting CPT 90677 · Snapshot 20261111T120946Z-9134e7f7