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 0.5 ml im
Low
$0
Average
$30
Median
$21
High
$132
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
29 hospitals; the 90th percentile is 8.5× 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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30 hospital rates
iThe hospitals that file a Medicaid 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 fee schedule · outpatient | 1 | $44 | $37 | $19 | 51% | — | $11 – $55 |
| 2 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $29 | $33 | $12 | 35% | — | $21 – $52 |
| 3 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $46 | $45 | $11 | 24% | — | $26 – $58 |
| 4 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 5 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 6 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 7 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 8 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $50 | $48 | $14 | 29% | — | $23 – $70 |
| 9 | Lake Charles Memorial Hospital Charles., LA percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 10 | Lancaster General Health Lancaster, PA facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 11 | Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 12 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | NYU Langone Mineola, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 15 | NYU Langone Brooklyn, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 16 | NYU Langone New York, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 17 | NYU Langone Hospital?Suffolk Patchogue, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 18 | Northwest Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 19 | Oro Valley Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 20 | REEDLEY COMMUNITY HOSPITAL Reedley, CA fee schedule · outpatient | 1 | $41 | $40 | $9 | 23% | — | $26 – $52 |
| 21 | SONORA COMMUNITY HOSPITAL Sonora, CA fee schedule · outpatient | 1 | $47 | $47 | $9 | 19% | — | $37 – $62 |
| 22 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 23 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 24 | Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO percent of total billed charges · outpatientfrom % of charges | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 25 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $118 | $118 | — | — | — | $118 – $118 |
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