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
$1
Average
$138
Median
$114
High
$416
Each hospital's average First Health rate, under the methodology and billing class chosen below.
100 hospitals; the 90th percentile is 8.9× 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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145 hospital rates
iThe hospitals that file a First Health 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 | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 2 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 1 | $193 | $193 | — | — | — | $193 – $193 |
| 3 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 4 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $193 | $193 | — | — | — | $193 – $193 |
| 5 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 6 | Amery Hospital Amery, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 7 | BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS Caldwell, TX fee schedule · inpatient | 1 | $219 | $219 | — | — | — | $219 – $219 |
| 8 | BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS Caldwell, TX fee schedule · outpatient | 1 | $219 | $219 | — | — | — | $219 – $219 |
| 9 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 1 | $202 | $202 | $58 | 29% | — | $144 – $260 |
| 10 | Berkshire Medical Center Great Barrington, MA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $339 | $339 | — | — | — | $339 – $339 |
| 11 | Berkshire Medical Center Great Barrington, MA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $332 | $332 | — | — | — | $332 – $332 |
| 12 | Berkshire Medical Center Great Barrington, MA professional · fee schedule · outpatient | 1 | $332 | $332 | — | — | — | $332 – $332 |
| 13 | Bexar County Hospital District San Antonio, TX percent of total billed charges · inpatientfrom % of charges | 1 | $39 | $39 | $3 | 7% | — | $37 – $42 |
| 14 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | $5 | 10% | — | $42 – $51 |
| 15 | Bon Secours Community Hospital Jervis, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 16 | Bon Secours Community Hospital Jervis, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 17 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 18 | CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER Houston, TX fee schedule · inpatient | 1 | $169 | $169 | $1 | 1% | — | $168 – $171 |
| 19 | CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER Houston, TX fee schedule · outpatient | 1 | $169 | $169 | $1 | 1% | — | $168 – $171 |
| 20 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 21 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 22 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $170 | $170 | — | — | — | $170 – $170 |
| 23 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $245 | $245 | — | — | — | $245 – $245 |
| 24 | DIGNITY HEALTH Merced, CA fee schedule · inpatient | 1 | $102 | $102 | — | — | — | $102 – $102 |
| 25 | DIGNITY HEALTH Merced, CA fee schedule · outpatient | 1 | $102 | $102 | — | — | — | $102 – $102 |
← Payers reporting CPT 90694 · Snapshot 20261111T120946Z-9134e7f7