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
Vacc aiiv4 no prsrv 0.5ml im
Low
$0
Average
$317
Median
$68
High
$3.3k
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
65 hospitals; the 90th percentile is 63.7× 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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73 hospital rates
iThe hospitals that file a Ambetter 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 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $24 | $62 | $54 | 87% | 1–10 | $24 – $138 |
| 2 | AnMed Health Anderson, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 3 | AnMed Health Anderson, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 4 | AnMed Health Cannon Pickens, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 5 | AnMed Health Cannon Pickens, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 6 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 7 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 8 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 9 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY other · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 10 | BAPTIST HEALTHCARE SYSTEM INC Albany, IN other · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 11 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY other · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 12 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY other · outpatient | 2 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 13 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY other · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 14 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY other · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 15 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY other · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 16 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY other · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 17 | BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS Caldwell, TX fee schedule · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 18 | Baxter County Regional Hospital, Inc. Home, AR facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 19 | Cass Regional Medical Center Harrisonville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $30 | $1 | 2% | — | $29 – $30 |
| 20 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $180 | $180 | — | — | — | $180 – $180 |
| 21 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $180 | $180 | — | — | — | $180 – $180 |
| 22 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $202 | $202 | — | — | — | $202 – $202 |
| 23 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 24 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $196 | $196 | — | — | — | $196 – $196 |
| 25 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Payers reporting CPT 90694 · Snapshot 20261111T120946Z-9134e7f7