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
Iiv4 vaccine splt 0.25 ml im
Low
$7
Average
$51
Median
$17
High
$763
Each hospital's average Kaiser rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 5.8× 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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33 hospital rates
iThe hospitals that file a Kaiser 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 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA percent of total billed charges · outpatientfrom % of charges | 2 | $31 | $31 | $19 | 62% | — | $12 – $50 |
| 2 | CENTENNIAL HOSPITAL A CAMPUS OF TMCA ENGLEWOOD, CO percent of total billed charges · outpatientfrom % of charges | 5 | $34 | $45 | $13 | 29% | — | $34 – $61 |
| 3 | Central Community Hospital Elkader, IA facility · fee schedule · both | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 4 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 5 | HCA HEALTHONE AURORA Aurora, CO percent of total billed charges · outpatientfrom % of charges | 5 | $34 | $45 | $13 | 29% | — | $34 – $61 |
| 6 | HCA HEALTHONE MOUNTAIN RIDGE Thornton, CO percent of total billed charges · outpatientfrom % of charges | 2 | $129 | $129 | $39 | 31% | — | $90 – $168 |
| 7 | HCA HEALTHONE NORTHEAST ER THORNTON, CO percent of total billed charges · outpatientfrom % of charges | 2 | $129 | $129 | $39 | 31% | — | $90 – $168 |
| 8 | HCA HEALTHONE SPALDING REHABILITATION AURORA, CO percent of total billed charges · outpatientfrom % of charges | 5 | $29 | $37 | $10 | 27% | — | $29 – $51 |
| 9 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 10 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $38 | $38 | $15 | 39% | — | $23 – $52 |
| 11 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 12 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 13 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 14 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · fee schedule · both | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 15 | Mercy Medical Center - Dubuque Dubuque, IA facility · fee schedule · both | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 16 | Mercy Medical Center - Dyersville Dyersville, IA facility · fee schedule · both | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 17 | Mercy Medical Center - New Hampton New Hampton, IA facility · fee schedule · both | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 18 | Mercy Medical Center-Clinton Inc Clinton, IA facility · fee schedule · both | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 19 | Piedmont Athens Regional Athens, GA percent of total billed charges · bothfrom % of charges | 2 | $12 | $12 | $8 | 64% | — | $4 – $20 |
| 20 | Piedmont Augusta Augusta, GA percent of total billed charges · bothfrom % of charges | 2 | $18 | $18 | $9 | 52% | — | $9 – $27 |
| 21 | Piedmont Columbus Regional - Midtown Columbus, GA percent of total billed charges · bothfrom % of charges | 2 | $16 | $16 | $11 | 66% | — | $5 – $27 |
| 22 | REEDLEY COMMUNITY HOSPITAL Reedley, CA percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 23 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 24 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 25 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
← Payers reporting CPT 90687 · Snapshot 20261113T090226Z-3ce6c0b8