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
Pcv21 Vaccine for Intramuscular Use
Low
$11
Average
$462
Median
$378
High
$4.0k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
223 hospitals; the 90th percentile is 2.3× 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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343 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 | Mary Hitchcock Memorial Hospital Lebanon, NH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $347 | $347 | — | — | 158 | $347 – $347 |
| 2 | NORTHERN MAINE MEDICAL CENTER FORT KENT, ME percent of total billed charges · outpatientfrom % of charges | 2 | $378 | $378 | $88 | 23% | 46 | $290 – $466 |
| 3 | Cheshire Medical Center Keene, NH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $333 | $333 | — | — | 34 | $333 – $333 |
| 4 | Eastern Maine Medical Center Bangor, ME facility · percent of total billed charges · outpatientfrom % of charges | 3 | $336 | $340 | $6 | 2% | 32 | $336 – $348 |
| 5 | Mercy Hospital Portland, ME facility · percent of total billed charges · outpatientfrom % of charges | 3 | $336 | $338 | $3 | 1% | 28 | $336 – $342 |
| 6 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 2 | $1.1k | $1.1k | $308 | 28% | 2–20 | $773 – $1.4k |
| 7 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY percent of total billed charges · outpatientfrom % of charges | 1 | $362 | $362 | — | — | 1–10 | $362 – $362 |
| 8 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY percent of total billed charges · outpatientfrom % of charges | 1 | $773 | $773 | — | — | 1–10 | $773 – $773 |
| 9 | Barnesville Hospital Association, Inc. Barnesville, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $203 | $203 | — | — | 1–10 | $203 – $203 |
| 10 | Maine Coast Regional Health Facilities Ellsworth, ME facility · percent of total billed charges · outpatientfrom % of charges | 1 | $340 | $340 | — | — | 1–10 | $340 – $340 |
| 11 | NATIONAL JEWISH HEALTH GOLDEN, CO percent of total billed charges · bothfrom % of charges | 1 | $338 | $338 | — | — | 1–10 | $338 – $338 |
| 12 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · other · outpatient | 1 | $11 | $11 | — | — | 1–10 | $11 – $11 |
| 13 | Wetzel County Hospital, Inc. New Martinsville, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $249 | $249 | — | — | 1–10 | $249 – $249 |
| 14 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 15 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 2 | $672 | $672 | $54 | 8% | — | $617 – $726 |
| 16 | ALICE_PECK_DAY_MEMORIAL_HOSPITAL LEBANON, NH percent of total billed charges · outpatientfrom % of charges | 1 | $331 | $331 | — | — | — | $331 – $331 |
| 17 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $366 | $366 | $45 | 12% | — | $321 – $412 |
| 18 | Acadia Hospital Bangor, ME facility · percent of total billed charges · outpatientfrom % of charges | 2 | $389 | $389 | — | — | — | $389 – $389 |
| 19 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 2 | $328 | $316 | $16 | 5% | — | $294 – $328 |
| 20 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 3 | $137 | $167 | $138 | 83% | — | $26 – $347 |
| 21 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $89 | $149 | $133 | 89% | — | $15 – $350 |
| 22 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $189 | $189 | $151 | 80% | — | $38 – $340 |
| 23 | Adena Health System Chillicothe, OH facility · percent of total billed charges · outpatientfrom % of charges | 5 | $140 | $163 | $134 | 82% | — | $27 – $340 |
| 24 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $328 | $328 | — | — | — | $328 – $328 |
| 25 | Ascension SE Wisconsin Hospital, Inc. Milwaukee, WI other · outpatient | 3 | $541 | $627 | $161 | 26% | — | $489 – $853 |
← Payers reporting CPT 90684 · Snapshot 20261111T120946Z-9134e7f7