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
Dtap-Ipv Vaccine Child 4-6 Yrs for Im Use
Low
$4
Average
$64
Median
$58
High
$268
Each hospital's average Molina rate, under the methodology and billing class chosen below.
202 hospitals; the 90th percentile is 11.7× 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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288 hospital rates
iThe hospitals that file a Molina 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 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 2 | $28 | $28 | $1 | 3% | 3–30 | $27 – $29 |
| 2 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | 1–10 | $13 – $13 |
| 3 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC fee schedule · both | 1 | $107 | $107 | — | — | 1–10 | $107 – $107 |
| 4 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC fee schedule · both | 1 | $107 | $107 | — | — | 1–10 | $107 – $107 |
| 5 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS percent of total billed charges · bothfrom % of charges | 1 | $40 | $40 | — | — | 1–10 | $40 – $40 |
| 6 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 7 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 8 | Aiken Regional Medical Centers North Augusta, SC fee schedule · both | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 9 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 10 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 11 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 12 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $60 | $60 | $28 | 47% | — | $32 – $88 |
| 13 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $91 | $91 | — | — | — | $91 – $91 |
| 14 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 15 | BRONXCARE HEALTH SYSTEM Bronx, NY other · outpatient | 2 | $33 | $35 | $4 | 10% | — | $33 – $42 |
| 16 | BRONXCARE HEALTH SYSTEM Bronx, NY other · outpatient | 2 | $33 | $35 | $4 | 10% | — | $33 – $42 |
| 17 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 18 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 19 | Bartow Regional Medical Center Bartow, FL facility · case rate · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 20 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 21 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · outpatientfrom % of charges | 2 | $105 | $105 | $56 | 53% | — | $49 – $161 |
| 22 | BayCare Alliant Hospital Dunedin, FL facility · case rate · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 23 | Baycare Hospital Wesley Chapel Chapel, FL facility · case rate · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 24 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 25 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · outpatientfrom % of charges | 2 | $105 | $105 | $56 | 53% | — | $49 – $161 |
← Payers reporting CPT 90696 · Snapshot 20261111T120946Z-9134e7f7