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
$88
Median
$54
High
$2.0k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
73 hospitals; the 90th percentile is 7.0× 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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78 hospital rates
iThe hospitals that file a WellCare 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 | Mary Hitchcock Memorial Hospital Lebanon, NH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $80 | $80 | — | — | 95 | $80 – $80 |
| 2 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $138 | $138 | — | — | 93 | $138 – $138 |
| 3 | Sarasota Memorial Hospital Sarasota, FL percent of total billed charges · outpatientfrom % of charges | 1 | $162 | $162 | — | — | 1–10 | $162 – $162 |
| 4 | Sarasota Memorial Hospital - Venice North Venice, FL percent of total billed charges · outpatientfrom % of charges | 1 | $162 | $162 | — | — | 1–10 | $162 – $162 |
| 5 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 6 | Appalachian Regional Healthcare, Inc. McDowell, KY percent of total billed charges · outpatientfrom % of charges | 2 | $51 | $51 | $0 | 1% | — | $51 – $52 |
| 7 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 8 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 9 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 10 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 11 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 12 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 13 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 14 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 15 | Baxter County Regional Hospital, Inc. Home, AR facility · fee schedule · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 16 | Benefis Hospitals Inc Helena, MT percent of total billed charges · outpatientfrom % of charges | 1 | $53 | $53 | $15 | 29% | — | $37 – $68 |
| 17 | CHI MEMORIAL HOSPITAL - GEORGIA Ringgold, GA fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 18 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 3 | $122 | $122 | — | — | — | $122 – $122 |
| 19 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 20 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 3 | $0 | $26 | $36 | 141% | — | $0 – $77 |
| 21 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 4 | $0 | $26 | $36 | 141% | — | $0 – $77 |
| 22 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 4 | $0 | $26 | $36 | 141% | — | $0 – $77 |
| 23 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 24 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $39 | $39 | $39 | 100% | — | $0 – $77 |
| 25 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
← Payers reporting CPT 90694 · Snapshot 20261111T120946Z-9134e7f7