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
$4
Average
$279
Median
$65
High
$25k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
139 hospitals; the 90th percentile is 22.9× 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.
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174 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 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC fee schedule · both | 1 | $269 | $269 | — | — | 14 | $269 – $269 |
| 2 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC fee schedule · both | 1 | $269 | $269 | — | — | 14 | $269 – $269 |
| 3 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 4 | ARH Tug Valley Health Services, Inc. Prestonsburg, KY percent of total billed charges · outpatientfrom % of charges | 1 | $229 | $229 | — | — | — | $229 – $229 |
| 5 | Aiken Regional Medical Centers North Augusta, SC fee schedule · both | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 6 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 7 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 8 | BRONXCARE HEALTH SYSTEM Bronx, NY other · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 9 | BRONXCARE HEALTH SYSTEM Bronx, NY other · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 10 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 11 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 12 | Bartow Regional Medical Center Bartow, FL facility · case rate · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 13 | BayCare Alliant Hospital Dunedin, FL facility · case rate · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 14 | Baycare Hospital Wesley Chapel Chapel, FL facility · case rate · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 15 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 16 | Bronson LakeView Hospital Paw Paw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 17 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 18 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 19 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 20 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 21 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 22 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · fee schedule · outpatient | 1 | $151 | $151 | — | — | — | $151 – $151 |
| 23 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 24 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · inpatientfrom % of charges | 2 | $48 | $48 | — | — | — | $48 – $48 |
| 25 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $48 | $48 | — | — | — | $48 – $48 |
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