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
DIPH,PERTUS(ACELL),TET,POLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE
Low
$0
Average
$234
Median
$110
High
$33.5k
Filter by billing methodology
Reflects a negotiated percentage of total billed charges.
Showing only prices reported under the percent of billed charges methodology. Choose another in the filter above to change the chart. 614 hospitals; the 90th percentile is 6.9× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Lucile Salter Packard Children's Hospital At Stanford PALO ALTO, CA | $185 | $202 | $68 | 34% | 374–410 | $132 – $297 |
| 2 | Mayo Clinic Rochester, MN | $80 | $79 | $2 | 3% | 260–386 | $74 – $84 |
| 3 | West Virginia University Hospitals, Inc. Morgantown, WV | $99 | $96 | $8 | 8% | 240–267 | $84 – $104 |
| 4 | Tufts Medical Center BOSTON, MA | $239 | $203 | $86 | 43% | 204–240 | $0 – $494 |
| 5 | St Peters Hospital Albany, NY | $102 | $102 | $10 | 9% | 175–292 | $92 – $111 |
| 6 | Mayo Clinic Health System Owatonna 55060-5503 | $80 | $78 | $8 | 10% | 168–276 | $13 – $84 |
| 7 | University of Wisconsin Hospital and Clinics Authority Madison, WI | $105 | $110 | $24 | 22% | 158–221 | $50 – $160 |
| 8 | City Hospital, Inc. Martinsburg, WV | $100 | $97 | $6 | 7% | 153–207 | $89 – $104 |
| 9 | Mayo Clinic Health System Mankato 56001-4752 | $80 | $77 | $7 | 9% | 137–236 | $13 – $84 |
| 10 | Samaritan Hospital Troy, NY | $92 | $101 | $13 | 13% | 99–225 | $5 – $111 |
Ask Claude or any MCP client for CPT 90696 pricing at a specific hospital — see how to connect.