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
$0
Average
$415
Median
$328
High
$15.9k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
234 hospitals; the 90th percentile is 31.8× 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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290 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 | Bexar County Hospital District San Antonio, TX other · outpatient | 1 | $137 | $137 | — | — | 2–20 | $137 – $137 |
| 2 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | 1–10 | $87 – $87 |
| 3 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · other · outpatient | 1 | $11 | $11 | — | — | 1–10 | $11 – $11 |
| 4 | Wetzel County Hospital, Inc. New Martinsville, WV facility · other · outpatient | 1 | $10 | $10 | — | — | 1–10 | $10 – $10 |
| 5 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 6 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $361 | $361 | — | — | — | $361 – $361 |
| 7 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $706 | $706 | — | — | — | $706 – $706 |
| 8 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $122 | $122 | $98 | 80% | — | $24 – $219 |
| 9 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $525 | $525 | $181 | 34% | — | $344 – $706 |
| 10 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 11 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 12 | Advocate Christ Medical Center Oak Lawn, IL facility · case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 13 | Advocate Condell Medical Center Libertyville, IL case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 14 | Advocate Good Samaritan Hospital Downers Grove, IL case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 15 | Advocate Good Shepherd Hospital Barrington, IL case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 16 | Advocate Illinois Masonic Medical Center Chicago, IL case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 17 | Advocate Lutheran General Hospital Park Ridge, IL case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 18 | Advocate Sherman Hospital Elgin, IL case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 19 | Advocate South Suburban Hospital Hazel Crest, IL case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 20 | Advocate Trinity Hospital Chicago, IL case rate · outpatient | 1 | $475 | $475 | — | — | — | $475 – $475 |
| 21 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $334 | $334 | — | — | — | $334 – $334 |
| 22 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $283 | $283 | — | — | — | $283 – $283 |
| 23 | Aurora BayCare Medical Center Green Bay, WI fee schedule · outpatient | 1 | $800 | $800 | — | — | — | $800 – $800 |
| 24 | Aurora Lakeland Medical Center Elkhorn, WI fee schedule · outpatient | 1 | $800 | $800 | — | — | — | $800 – $800 |
| 25 | Aurora Medical Center Bay Area Marinette, WI fee schedule · outpatient | 1 | $800 | $800 | — | — | — | $800 – $800 |
← Payers reporting CPT 90684 · Snapshot 20261111T120946Z-9134e7f7