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
DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SYRNG
Low
$0
Average
$217
Median
$172
High
$769
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
197 hospitals; the 90th percentile is 5.0× 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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296 hospital rates
iThe hospitals that file a Anthem 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $669 | $546 | $174 | 32% | — | $300 – $669 |
| 3 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · outpatientfrom % of charges | 3 | $205 | $280 | $206 | 74% | — | $78 – $648 |
| 4 | ARH Tug Valley Health Services, Inc. Prestonsburg, KY fee schedule · outpatient | 1 | $188 | $188 | — | — | — | $188 – $188 |
| 5 | ARH Tug Valley Health Services, Inc. Prestonsburg, KY percent of total billed charges · outpatientfrom % of charges | 1 | $225 | $225 | — | — | — | $225 – $225 |
| 6 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $170 | $170 | $21 | 12% | — | $149 – $191 |
| 7 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $154 | $154 | — | — | — | $154 – $154 |
| 8 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 3 | $159 | $159 | — | — | — | $159 – $159 |
| 9 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 4 | $349 | $359 | $49 | 14% | — | $313 – $428 |
| 10 | Appalachian Regional Healthcare, Inc. Hazard, KY fee schedule · outpatient | 1 | $188 | $188 | — | — | — | $188 – $188 |
| 11 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 12 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $150 | $150 | — | — | — | $150 – $150 |
| 13 | Aurora BayCare Medical Center Green Bay, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 14 | Aurora Lakeland Medical Center Elkhorn, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 15 | Aurora Medical Center Bay Area Marinette, WI fee schedule · outpatient | 3 | $188 | $178 | $15 | 8% | — | $157 – $188 |
| 16 | Aurora Medical Center Burlington Burlington, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 17 | Aurora Medical Center Fond du Lac Fond Du Lac, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 18 | Aurora Medical Center Grafton Grafton, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 19 | Aurora Medical Center Kenosha Kenosha, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 20 | Aurora Medical Center Manitowoc Two Rivers, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 21 | Aurora Medical Center Mount Pleasant Mount Pleasant, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 22 | Aurora Medical Center Oshkosh Oshkosh, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 23 | Aurora Medical Center Sheboygan County Sheboygan, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 24 | Aurora Medical Center Summit Summit, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
| 25 | Aurora Medical Center Washington County Hartford, WI fee schedule · outpatient | 2 | $172 | $172 | $16 | 9% | — | $157 – $188 |
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