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
$152
Median
$120
High
$2.0k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
72 hospitals; the 90th percentile is 15.5× 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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78 hospital rates
iThe hospitals that file a WellCare 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 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $166 | $166 | — | — | 6–60 | $166 – $166 |
| 2 | Fairview Health Services Minneapolis, MN other · outpatient | 1 | $166 | $166 | — | — | 4–40 | $166 – $166 |
| 3 | ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges | 1 | $214 | $214 | — | — | — | $214 – $214 |
| 4 | Aiken Regional Medical Centers North Augusta, SC fee schedule · both | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 5 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $186 | $186 | — | — | — | $186 – $186 |
| 6 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 7 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 8 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 9 | BLUE RIDGE REGIONAL HOSPITAL Spruce Pine, NC percent of total billed charges · outpatientfrom % of charges | 1 | $201 | $201 | — | — | — | $201 – $201 |
| 10 | CAREPARTNERS REHABILITATION HOSPITAL Asheville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $702 | $702 | — | — | — | $702 – $702 |
| 11 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 3 | $221 | $221 | — | — | — | $221 – $221 |
| 12 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 13 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 14 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 15 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 16 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $83 | $83 | — | — | — | $83 – $83 |
| 17 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $135 | $103 | $57 | 55% | — | $5 – $138 |
| 18 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $83 | $83 | — | — | — | $83 – $83 |
| 19 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 20 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 21 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 3 | $0 | $3 | $6 | 223% | — | $0 – $17 |
| 22 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 4 | $0 | $12 | $37 | 293% | — | $0 – $133 |
| 23 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 4 | $0 | $12 | $37 | 293% | — | $0 – $133 |
| 24 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $73 | $73 | — | — | — | $73 – $73 |
| 25 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $0 | $14 | $36 | 262% | — | $0 – $133 |
← Payers reporting CPT 90697 · Snapshot 20261111T120946Z-9134e7f7