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
Rv5 Vaccine 3 Dose Schedule Live for Oral Use
Low
$0
Average
$526
Median
$107
High
$25.1k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
68 hospitals; the 90th percentile is 6.2× 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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76 hospital rates
iThe hospitals that file a Tricare 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 | Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient | 1 | $109 | $109 | — | — | 13 | $109 – $109 |
| 2 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $105 | $105 | — | — | — | $105 – $105 |
| 3 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $102 | $102 | — | — | — | $102 – $102 |
| 4 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $102 | $102 | — | — | — | $102 – $102 |
| 5 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $102 | $102 | — | — | — | $102 – $102 |
| 6 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 7 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 8 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $493 | $493 | — | — | — | $493 – $493 |
| 9 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · both | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 10 | Bay Park Community Hospital Oregon, OH facility · fee schedule · outpatient | 1 | $204 | $204 | — | — | — | $204 – $204 |
| 11 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 12 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY professional · fee schedule · outpatient | 4 | $105 | $105 | — | — | — | $105 – $105 |
| 13 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $142 | $142 | — | — | — | $142 – $142 |
| 14 | Calhoun Liberty Hospital Association Inc Blountstown, FL percent of total billed charges · bothfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 15 | CentraState Medical Center Freehold Township, NJ fee schedule · outpatient | 2 | $86 | $86 | $5 | 5% | — | $81 – $90 |
| 16 | Chilton Medical Center Pompton Plains, NJ fee schedule · outpatient | 2 | $89 | $89 | $2 | 2% | — | $87 – $90 |
| 17 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $107 | $107 | $56 | 52% | — | $51 – $163 |
| 18 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $388 | $266 | $172 | 64% | — | $22 – $388 |
| 19 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $120 | $120 | $95 | 79% | — | $25 – $216 |
| 20 | Fisher-Titus Medical Center Norwalk, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $241 | $241 | $34 | 14% | — | $206 – $275 |
| 21 | Fisher-Titus Medical Center Norwalk, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $226 | $226 | $32 | 14% | — | $194 – $258 |
| 22 | GLENS FALLS HOSPITAL INC Falls, NY professional · fee schedule · outpatient | 4 | $105 | $105 | — | — | — | $105 – $105 |
| 23 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · both | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 24 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $142 | $142 | — | — | — | $142 – $142 |
| 25 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · inpatientfrom % of charges | 1 | $183 | $183 | — | — | — | $183 – $183 |
← Payers reporting CPT 90680 · Snapshot 20261111T120946Z-9134e7f7