Combined DTaP, polio, Hib and hepatitis B vaccine

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SYRNG

Tricare pricing summary

Low

Average

$162

Median

$155

High

$776

Tricare rate distribution

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85 hospital rates

#		Plans
1	Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges	1	$250	$250	—	—	1–10	$250 – $250
2	Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient	1	$166	$166	—	—	1–10	$166 – $166
3	ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient	4	$166	$166	—	—	—	$166 – $166
4	Anderson Hospital Maryville, IL facility · fee schedule · outpatient	1	$161	$161	—	—	—	$161 – $161
5	Anderson Hospital Maryville, IL professional · other · outpatient	1	$164	$164	—	—	—	$164 – $164
6	Bluffton Health System LLC Bluffton, IN facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
7	Bon Secours Community Hospital Jervis, NY facility · fee schedule · outpatient	1	$166	$166	—	—	—	$166 – $166
8	Brandon HMA LLC Brandon, MS facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
9	CORNING HOSPITAL Corning, NY facility · other · outpatient	2	$221	$221	—	—	—	$221 – $221
10	CentraState Medical Center Freehold Township, NJ fee schedule · outpatient	2	$86	$86	$5	5%	—	$81 – $90
11	Chilton Medical Center Pompton Plains, NJ fee schedule · outpatient	2	$89	$89	$2	2%	—	$87 – $90
12	Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges	1	$54	$128	$104	82%	—	$54 – $276
13	Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient	1	$166	$166	—	—	—	$166 – $166
14	Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient	1	$166	$166	—	—	—	$166 – $166
15	Dupont Hospital LLC Wayne, IN facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
16	Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient	1	$166	$119	$66	56%	—	$25 – $166
17	GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient	1	$221	$221	—	—	—	$221 – $221
18	Good Samaritan Hospital Suffern, NY facility · fee schedule · outpatient	1	$166	$166	—	—	—	$166 – $166
19	HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges	1	$140	$140	—	—	—	$140 – $140
20	Hackettstown Medical Center Hackettstown, NJ fee schedule · outpatient	2	$89	$89	$2	2%	—	$87 – $90
21	Hospital Authority of Colquitt County Moultrie, GA fee schedule · both	1	$36	$80	$54	67%	—	$35 – $150
22	IOM Health System LP Fort Wayne, IN facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
23	Jackson HMA LLC Jackson, MS facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
24	Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient	1	$166	$166	—	—	—	$166 – $166
25	Kaweah Health Mental Health Hospital Visalia, CA facility · fee schedule · outpatient	1	$776	$776	$0	0%	—	$776 – $776