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
$11
Average
$99
Median
$80
High
$763
Each hospital's average Highmark rate, under the methodology and billing class chosen below.
52 hospitals; the 90th percentile is 1.9× 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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64 hospital rates
iThe hospitals that file a Highmark 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 | Clarion Hospital Clarion, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $129 | $129 | — | — | 3–30 | $129 – $129 |
| 2 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $129 | $129 | — | — | 2–20 | $129 – $129 |
| 3 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 11 | $96 | $96 | $2 | 2% | — | $90 – $96 |
| 4 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 12 | $96 | $89 | $23 | 26% | — | $14 – $96 |
| 5 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 6 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · inpatient | 11 | $96 | $96 | $2 | 2% | — | $90 – $96 |
| 7 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 12 | $96 | $89 | $23 | 26% | — | $14 – $96 |
| 8 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 9 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 10 | Central Community Hospital Elkader, IA facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 11 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 12 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 13 | ERIE COUNTY MEDICAL CENTER CORPORATION Buffalo, NY fee schedule · outpatient | 7 | $77 | $73 | $21 | 28% | — | $42 – $93 |
| 14 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 3 | $77 | $79 | $5 | 6% | — | $74 – $88 |
| 15 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · inpatient | 11 | $96 | $96 | $2 | 2% | — | $90 – $96 |
| 16 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 12 | $96 | $89 | $23 | 26% | — | $14 – $96 |
| 17 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 18 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · inpatient | 11 | $96 | $96 | $2 | 2% | — | $90 – $96 |
| 19 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · outpatient | 12 | $96 | $89 | $23 | 26% | — | $14 – $96 |
| 20 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $221 | $221 | — | — | — | $221 – $221 |
| 21 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $149 | $149 | — | — | — | $149 – $149 |
| 22 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 23 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 24 | Mercy Medical Center - Dubuque Dubuque, IA facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 25 | Mercy Medical Center - Dyersville Dyersville, IA facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
← Payers reporting CPT 90694 · Snapshot 20261111T120946Z-9134e7f7