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
$328
Median
$418
High
$538
Each hospital's average Phcs rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 3371.2× 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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53 hospital rates
iThe hospitals that file a Phcs 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 | Bon Secours Community Hospital Jervis, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $429 | $429 | — | — | — | $429 – $429 |
| 2 | Bon Secours Community Hospital Jervis, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $429 | $429 | — | — | — | $429 – $429 |
| 3 | Brandon HMA LLC Brandon, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 4 | Brandon HMA LLC Brandon, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 5 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $524 | $524 | $12 | 2% | — | $513 – $536 |
| 6 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $542 | $542 | $12 | 2% | — | $530 – $553 |
| 7 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 1 | $0 | $0 | $0 | 97% | — | $0 – $1 |
| 8 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | $0 | 97% | — | $0 – $1 |
| 9 | Good Samaritan Hospital Suffern, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $429 | $429 | — | — | — | $429 – $429 |
| 10 | Good Samaritan Hospital Suffern, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $429 | $429 | — | — | — | $429 – $429 |
| 11 | La Porte Hospital Company LLC La Porte, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | La Porte Hospital Company LLC La Porte, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $186 | $186 | — | — | — | $186 – $186 |
| 14 | MedStar Georgetown Hospital Washington, DC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $363 | $363 | — | — | — | $363 – $363 |
| 15 | MedStar Georgetown Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $363 | $363 | — | — | — | $363 – $363 |
| 16 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $538 | $538 | — | — | — | $538 – $538 |
| 17 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $441 | $441 | — | — | — | $441 – $441 |
| 18 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $244 | $244 | — | — | — | $244 – $244 |
| 19 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $349 | $349 | — | — | — | $349 – $349 |
| 20 | MedStar St. Mary's Hospital Leonardtown, MD percent of total billed charges · outpatientfrom % of charges | 1 | $196 | $196 | — | — | — | $196 – $196 |
| 21 | MedStar Union Memorial Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $436 | $436 | — | — | — | $436 – $436 |
| 22 | MedStar Washington Hospital Center NW, WA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $385 | $385 | — | — | — | $385 – $385 |
| 23 | MedStar Washington Hospital Center NW, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $385 | $385 | — | — | — | $385 – $385 |
| 24 | Medical Center of the Rockies Loveland, CO percent of total billed charges · inpatientfrom % of charges | 1 | $389 | $389 | — | — | — | $389 – $389 |
| 25 | Medical Center of the Rockies Loveland, CO percent of total billed charges · outpatientfrom % of charges | 1 | $389 | $389 | — | — | — | $389 – $389 |
← Payers reporting CPT 90697 · Snapshot 20261111T120946Z-9134e7f7