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
$1
Average
$397
Median
$313
High
$16.0k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
442 hospitals; the 90th percentile is 7.3× 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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662 hospital rates
iThe hospitals that file a Molina 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 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 3 | $307 | $345 | $55 | 16% | 111–120 | $307 – $422 |
| 2 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 6 | $307 | $300 | $30 | 10% | 106 | $257 – $339 |
| 3 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | $2 | 2% | 92 | $129 – $133 |
| 4 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 3 | $307 | $345 | $55 | 16% | 47 | $307 – $422 |
| 5 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 2 | $411 | $526 | $374 | 71% | 40 | $143 – $1.1k |
| 6 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 3 | $307 | $345 | $55 | 16% | 18–27 | $307 – $422 |
| 7 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC percent of total billed charges · bothfrom % of charges | 3 | $459 | $518 | $319 | 62% | 17 | $174 – $908 |
| 8 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 3 | $459 | $518 | $319 | 62% | 17 | $174 – $908 |
| 9 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $596 | $596 | — | — | 14–23 | $596 – $596 |
| 10 | St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID percent of total billed charges · outpatientfrom % of charges | 2 | $278 | $246 | $51 | 21% | 5–50 | $173 – $289 |
| 11 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $178 | $403 | $400 | 99% | 4–40 | $0 – $919 |
| 12 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $178 | $403 | $400 | 99% | 4–40 | $0 – $919 |
| 13 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 1 | $292 | $292 | — | — | 4–40 | $292 – $292 |
| 14 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 2 | $314 | $345 | $228 | 66% | 3–30 | $107 – $646 |
| 15 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $353 | $353 | $17 | 5% | 2–20 | $336 – $371 |
| 16 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 1 | $88 | $88 | $1 | 2% | 2–20 | $86 – $89 |
| 17 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 2 | $365 | $365 | $58 | 16% | 2–20 | $307 – $422 |
| 18 | Methodist Hospitals of Dallas Mansfield, TX percent of total billed charges · bothfrom % of charges | 1 | $280 | $280 | $23 | 8% | 2–20 | $257 – $304 |
| 19 | Methodist Medical Center of Illinois Peoria, IL percent of total billed charges · outpatientfrom % of charges | 1 | $88 | $88 | $1 | 2% | 2–20 | $86 – $89 |
| 20 | Mount Carmel Grove City Grove City, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $181 | $181 | $108 | 60% | 2–20 | $73 – $289 |
| 21 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $596 | $596 | — | — | 2–20 | $596 – $596 |
| 22 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS percent of total billed charges · bothfrom % of charges | 1 | $346 | $346 | $71 | 21% | 2–20 | $275 – $417 |
| 23 | St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID other · both | 2 | $173 | $173 | — | — | 2–20 | $173 – $173 |
| 24 | St Luke's McCall, LTD McCall, ID percent of total billed charges · bothfrom % of charges | 2 | $384 | $340 | $70 | 21% | 2–20 | $238 – $399 |
| 25 | St Luke's Regional Medical Center, LTD Mountain Home, ID percent of total billed charges · outpatientfrom % of charges | 2 | $265 | $234 | $49 | 21% | 2–20 | $164 – $275 |
← Payers reporting CPT 90677 · Snapshot 20261111T120946Z-9134e7f7