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
DIPH,PERTUS(ACEL),TET PED (DTAP) 25-58-10 LF-MCG-LF/0.5ML IM SYRG [19451]
Low
$0
Average
$95
Median
$64
High
$5.3k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1194 hospitals; the 90th percentile is 5.9× 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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1,878 hospital rates
iThe hospitals that file a Aetna 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 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 2 | $31 | $31 | $0 | 1% | 37 | $30 – $31 |
| 2 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | 29 | $50 – $50 |
| 3 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | 20 | $50 – $50 |
| 4 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 1 | $33 | $33 | — | — | 20 | $33 – $33 |
| 5 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | 14 | $50 – $50 |
| 6 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | 12 | $50 – $50 |
| 7 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $133 | $99 | $81 | 81% | 6–60 | $0 – $193 |
| 8 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $133 | $99 | $81 | 81% | 6–60 | $0 – $193 |
| 9 | Duke University Hospital Durham, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $69 | $69 | $13 | 19% | 3–30 | $56 – $82 |
| 10 | Duke University Hospital Raleigh, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $69 | $69 | $13 | 19% | 3–30 | $56 – $82 |
| 11 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $105 | $97 | $13 | 14% | 3–30 | $78 – $106 |
| 12 | University of Virginia Medical Center Charlottesville, VA percent of total billed charges · bothfrom % of charges | 4 | $45 | $44 | $9 | 19% | 3–30 | $31 – $54 |
| 13 | WINNESHIEK MEDICAL CENTER Decorah, IA percent of total billed charges · outpatientfrom % of charges | 3 | $67 | $68 | $2 | 3% | 3–30 | $66 – $71 |
| 14 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | — | — | 2–20 | $36 – $36 |
| 15 | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA percent of total billed charges · outpatientfrom % of charges | 1 | $99 | $99 | $56 | 56% | 2–20 | $43 – $154 |
| 16 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 2 | $37 | $37 | — | — | 2–20 | $37 – $37 |
| 17 | Mon Health Medical Center Morgantown, WV percent of total billed charges · outpatientfrom % of charges | 1 | $65 | $65 | $8 | 12% | 2–20 | $57 – $73 |
| 18 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | 2–20 | $50 – $50 |
| 19 | St. Charles Madras Madras, OR percent of total billed charges · bothfrom % of charges | 2 | $49 | $53 | $31 | 59% | 2–20 | $20 – $95 |
| 20 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 2 | $60 | $60 | $4 | 6% | 2–20 | $56 – $64 |
| 21 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $39 | $41 | $6 | 14% | 1–10 | $35 – $49 |
| 22 | EATON RAPIDS MEDICAL CENTER Eaton Rapids, MI percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | 1–10 | $37 – $37 |
| 23 | Eisenhower Medical Center Rancho Mirage, CA fee schedule · inpatient | 4 | $62 | $62 | — | — | 1–10 | $62 – $62 |
| 24 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $32 | $32 | — | — | 1–10 | $32 – $32 |
| 25 | Mayo Clinic Health System Owatonna 55060-5503 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | 1–10 | $37 – $37 |
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