DTaP-IPV vaccine for children ages 4 to 6

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Dtap-Ipv Vaccine Child 4-6 Yrs for Im Use

Payers reporting CPT 90696

Payer pricing summary

Low

$25

Average

$123

Median

$89

High

$420

Payer rate distribution

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#
1	Wellmark fee schedule · outpatient · +17 other terms	28	$63	$63	$2	3%	156	$61 – $75
2	Anthem fee schedule · outpatient · +21 other terms	76	$69	$84	$51	60%	4–40	$3 – $367
3	Tricare professional · fee schedule · outpatient · +17 other terms	21	$66	$67	$1	2%	2–20	$65 – $68
4	UnitedHealthcare fee schedule · outpatient · +29 other terms	453	$143	$168	$124	74%	1–10	$0 – $957
5	Blue Cross Blue Shield fee schedule · outpatient · +30 other terms	237	$126	$158	$97	61%	—	$0 – $420
6	Cigna fee schedule · outpatient · +23 other terms	223	$115	$196	$118	60%	—	$0 – $602
7	Humana fee schedule · outpatient · +25 other terms	181	$67	$240	$699	291%	—	$9 – $8.3k
8	Aetna fee schedule · outpatient · +28 other terms	119	$74	$217	$691	319%	—	$0 – $8.4k
9	Medica fee schedule · outpatient · +19 other terms	52	$100	$104	$60	58%	—	$16 – $231
10	Molina facility · case rate · outpatient · +25 other terms	37	$20	$15	$7	45%	—	$6 – $36
11	Caresource fee schedule · outpatient · +16 other terms	28	$68	$45	$13	29%	—	$37 – $68
12	Bcbs Tx fee schedule · outpatient · +4 other terms	26	$269	$257	$75	29%	—	$56 – $415
13	Medcost professional · percent of total billed charges · outpatientfrom % of charges · +7 other terms	26	$80	$75	$11	14%	—	$56 – $92
14	MultiPlan fee schedule · outpatient · +20 other terms	26	$183	$159	$97	61%	—	$4 – $455
15	Amerihealth Caritas facility · fee schedule · outpatient · +13 other terms	23	$12	$13	$3	24%	—	$10 – $23
16	Highmark facility · fee schedule · outpatient · +19 other terms	21	$12	$40	$32	80%	—	$11 – $101
17	Regence facility · fee schedule · both · +15 other terms	19	$63	$73	$34	47%	—	$30 – $204
18	Premera facility · fee schedule · both · +9 other terms	18	$63	$73	$34	46%	—	$41 – $204
19	Carefirst facility · fee schedule · both · +9 other terms	17	$63	$74	$34	45%	—	$63 – $204
20	Excellus facility · fee schedule · both · +13 other terms	17	$63	$72	$29	40%	—	$63 – $204
21	Medicaid fee schedule · both · +15 other terms	17	$65	$37	$37	99%	—	$16 – $113
22	Aetna Better Health facility · fee schedule · outpatient · +14 other terms	15	$17	$21	$15	69%	—	$10 – $47
23	Beechstreet percent of total billed charges · inpatientfrom % of charges · +3 other terms	15	$162	$212	$148	70%	—	$72 – $549
24	Bcbs La fee schedule · outpatient · +2 other terms	14	$69	$68	$2	4%	—	$63 – $71
25	WellCare other · outpatient · +18 other terms	14	$83	$85	$42	49%	—	$29 – $196

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