Quadrivalent flu vaccine, 0.25 mL intramuscular shot

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Iiv4 vaccine splt 0.25 ml im

Payers reporting CPT 90687

Payer pricing summary

Low

Average

$104

Median

$29

High

$1.6k

Payer rate distribution

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#
1	Cigna fee schedule · outpatient · +17 other terms	242	$16	$30	$21	70%	—	$5 – $88
2	Blue Cross Blue Shield fee schedule · outpatient · +23 other terms	194	$17	$23	$13	57%	—	$0 – $60
3	UnitedHealthcare fee schedule · outpatient · +23 other terms	170	$12	$91	$943	1032%	—	$3 – $11.6k
4	Aetna fee schedule · outpatient · +20 other terms	121	$11	$232	$1.1k	475%	—	$3 – $8.4k
5	Humana fee schedule · outpatient · +17 other terms	91	$26	$43	$31	71%	—	$9 – $92
6	Anthem fee schedule · outpatient · +17 other terms	82	$13	$15	$6	40%	—	$9 – $44
7	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$36	$33	$11	33%	—	$13 – $57
8	Molina fee schedule · outpatient · +17 other terms	30	$12	$18	$16	85%	—	$9 – $93
9	Highmark facility · fee schedule · outpatient · +10 other terms	19	$12	$29	$31	106%	—	$10 – $128
10	Regence professional · fee schedule · outpatient · +7 other terms	19	$10	$10	—	—	—	$10 – $10
11	Aetna Better Health fee schedule · outpatient · +8 other terms	18	$11	$52	$99	191%	—	$11 – $352
12	Amerihealth Caritas facility · fee schedule · outpatient · +8 other terms	18	$12	$12	$1	10%	—	$11 – $16
13	Healthpartners fee schedule · outpatient · +2 other terms	18	$12	$12	$0	2%	—	$12 – $13
14	Carefirst facility · fee schedule · both · +3 other terms	17	$9	$12	$6	49%	—	$9 – $30
15	Excellus facility · fee schedule · both · +5 other terms	17	$9	$12	$6	49%	—	$9 – $30
16	Premera facility · fee schedule · both · +3 other terms	17	$9	$12	$6	49%	—	$9 – $30
17	Wellmark facility · fee schedule · both · +10 other terms	17	$9	$11	$5	46%	—	$9 – $30
18	Caresource facility · case rate · outpatient · +6 other terms	15	$9	$10	$2	23%	—	$6 – $16
19	Medica fee schedule · both · +9 other terms	15	$19	$18	$5	27%	—	$9 – $23
20	Optum facility · case rate · outpatient · +10 other terms	13	$9	$11	$4	34%	—	$8 – $18
21	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$11	$11	$3	28%	—	$6 – $14
22	Bcbs Nj fee schedule · outpatient · +5 other terms	12	$10	$10	$1	6%	—	$9 – $10
23	Devoted facility · fee schedule · outpatient · +6 other terms	12	$10	$172	$576	334%	—	$5 – $2.2k
24	Kaiser facility · fee schedule · both · +7 other terms	12	$9	$13	$7	52%	—	$9 – $30
25	Tricare facility · fee schedule · outpatient · +1 other terms	12	$61	$3.2k	$10.3k	323%	—	$10 – $37.5k

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