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
$93
Median
$69
High
$8.2k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1244 hospitals; the 90th percentile is 4.7× 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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1,732 hospital rates
iThe hospitals that file a Cigna 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 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 2 | $83 | $78 | $11 | 14% | 42–69 | $61 – $89 |
| 2 | Mercy Hospitals East Communities Washington, MO professional · fee schedule · outpatient | 3 | $27 | $27 | $6 | 21% | 27 | $22 – $33 |
| 3 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | 22 | $49 – $49 |
| 4 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | — | — | 19 | $47 – $47 |
| 5 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | 16 | $50 – $50 |
| 6 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 1 | $28 | $28 | — | — | 12 | $28 – $28 |
| 7 | Northside Hospital, Inc. Lawrenceville, GA other · outpatient | 5 | $113 | $97 | $35 | 36% | 4–40 | $27 – $116 |
| 8 | Northside Hospital, Inc. Atlanta, GA other · outpatient | 5 | $113 | $98 | $34 | 35% | 4–40 | $29 – $116 |
| 9 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $48 | $48 | — | — | 2–20 | $48 – $48 |
| 10 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | 2–20 | $9 – $9 |
| 11 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | 2–20 | $50 – $50 |
| 12 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | 2–20 | $49 – $49 |
| 13 | Arkansas Childrens Northwest Springdale, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $104 | $104 | — | — | 1–10 | $104 – $104 |
| 14 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $67 | $72 | $10 | 14% | 1–10 | $60 – $85 |
| 15 | Brunswick Community Hospital, LLC Bolivia, NC percent of total billed charges · outpatientfrom % of charges | 1 | $59 | $59 | — | — | 1–10 | $59 – $59 |
| 16 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $32 | $32 | — | — | 1–10 | $32 – $32 |
| 17 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | 1–10 | $37 – $37 |
| 18 | Mayo Clinic Health System Owatonna 55060-5503 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | 1–10 | $37 – $37 |
| 19 | Mayo Clinic Health System Barron, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $38 | $38 | $0 | 1% | 1–10 | $37 – $38 |
| 20 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $70 | $70 | $36 | 51% | 1–10 | $34 – $106 |
| 21 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | — | — | 1–10 | $47 – $47 |
| 22 | Self Regional Healthcare Greenwood, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $195 | $195 | — | — | 1–10 | $195 – $195 |
| 23 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | — | — | 1–10 | $47 – $47 |
| 24 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 1 | $48 | $48 | — | — | 1–10 | $48 – $48 |
| 25 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA percent of total billed charges · outpatientfrom % of charges | 1 | $51 | $51 | $41 | 81% | — | $10 – $93 |
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