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
$3
Average
$181
Median
$30
High
$1.3k
Each hospital's average Medicare rate, under the methodology and billing class chosen below.
18 hospitals; the 90th percentile is 64.0× 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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20 hospital rates
iThe hospitals that file a Medicare 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 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 2 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 3 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL per diem · inpatient | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 4 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 5 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Canon City, CO percent of total billed charges · outpatientfrom % of charges | 1 | $166 | $166 | — | — | — | $166 – $166 |
| 7 | COMMONSPIRIT KANSAS, INC. Ulysses, KS percent of total billed charges · outpatientfrom % of charges | 1 | $355 | $355 | — | — | — | $355 – $355 |
| 8 | Lake Charles Memorial Hospital Charles., LA fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 9 | Lancaster General Health Lancaster, PA facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 10 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 11 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 12 | Public Hospital District No 4 King County WA Snoqualmie, WA fee schedule · both | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 13 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS percent of total billed charges · bothfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 14 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CANTON, MS other · both | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 15 | ThedaCare Regional Medical Center-Berlin Inc WI 54971-9286; N2930 State Rd 22 Wautoma, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | $10 | 32% | — | $21 – $40 |
| 16 | Thedacare Regional Medical Center-New London Inc WI 54961; 370 S. Main St. Clintonville, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | $11 | 32% | — | $25 – $48 |
| 17 | Thedacare Regional Medical Center-Shawano Inc Shawano, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | $10 | 32% | — | $21 – $40 |
| 18 | Thedacare Regional Medical Center-Waupaca Inc Waupaca, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $33 | $33 | $10 | 32% | — | $23 – $43 |
| 19 | Thedacare Regional Medical Center-Wild Rose Inc Wild Rose, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | $10 | 32% | — | $21 – $40 |
| 20 | Westchester Medical Center Valhalla, NY facility · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
← Payers reporting CPT 90688 · Snapshot 20261112T181611Z-3fa9fb76