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
$3
Average
$299
Median
$104
High
$1.9k
Each hospital's average Medicare rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 59.3× 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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19 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 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $138 | $138 | — | — | 123 | $138 – $138 |
| 2 | Eisenhower Medical Center Rancho Mirage, CA fee schedule · inpatient | 4 | $77 | $77 | — | — | 2–20 | $77 – $77 |
| 3 | Eskenazi Health Indianapolis, IN facility · other · outpatient | 1 | $140 | $140 | — | — | 1–10 | $140 – $140 |
| 4 | Tufts Medical Center BOSTON, MA other · both | 1 | $437 | $437 | — | — | 1–10 | $437 – $437 |
| 5 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 1 | $5.5k | $5.5k | — | — | — | $5.5k – $5.5k |
| 6 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 2 | $43 | $43 | $8 | 20% | — | $34 – $51 |
| 7 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 8 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 9 | Benefis Hospitals Inc Helena, MT percent of total billed charges · outpatientfrom % of charges | 1 | $53 | $53 | $15 | 29% | — | $37 – $68 |
| 10 | Berkshire Medical Center Great Barrington, MA facility · fee schedule · outpatient | 2 | $105 | $105 | — | — | — | $105 – $105 |
| 11 | Berkshire Medical Center Great Barrington, MA professional · fee schedule · outpatient | 2 | $76 | $76 | — | — | — | $76 – $76 |
| 12 | Bon Secours Community Hospital Jervis, NY facility · fee schedule · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 13 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 14 | CATHOLIC HEALTH INITIATIVES COLORADO Canon City, CO percent of total billed charges · outpatientfrom % of charges | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 15 | COMMONSPIRIT KANSAS, INC. Ulysses, KS percent of total billed charges · outpatientfrom % of charges | 1 | $258 | $258 | — | — | — | $258 – $258 |
| 16 | Fairview Hospital Great Barrington, MA facility · fee schedule · outpatient | 2 | $132 | $132 | $2 | 1% | — | $130 – $133 |
| 17 | Fairview Hospital Great Barrington, MA professional · fee schedule · outpatient | 2 | $76 | $76 | — | — | — | $76 – $76 |
| 18 | Good Samaritan Hospital Suffern, NY facility · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 19 | St Anthony Community Hospital Warwick, NY facility · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
← Payers reporting CPT 90694 · Snapshot 20261111T120946Z-9134e7f7