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
$1
Average
$55
Median
$36
High
$1.4k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
313 hospitals; the 90th percentile is 9.4× 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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435 hospital rates
iThe hospitals that file a Molina 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 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $41 | $42 | $4 | 10% | 3–30 | $37 – $47 |
| 2 | San Bernardino County Redlands, CA facility · other · outpatient | 1 | $14 | $14 | — | — | 3–30 | $14 – $14 |
| 3 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $9 | $9 | $0 | 1% | 2–20 | $9 – $9 |
| 4 | Richland Memorial Hospital Inc Olney, IL percent of total billed charges · outpatientfrom % of charges | 2 | $11 | $11 | $2 | 18% | 2–20 | $9 – $13 |
| 5 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 2 | $13 | $13 | $0 | 1% | 2–20 | $13 – $13 |
| 6 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC fee schedule · both | 1 | $50 | $50 | — | — | 1–10 | $50 – $50 |
| 7 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC fee schedule · both | 1 | $50 | $50 | — | — | 1–10 | $50 – $50 |
| 8 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 2 | $35 | $35 | $17 | 49% | 1–10 | $18 – $51 |
| 9 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 10 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $10 | $1 | 5% | — | $10 – $11 |
| 11 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 2 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 12 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 2 | $25 | $25 | $0 | 0% | — | $25 – $25 |
| 13 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 4 | $19 | $19 | $2 | 12% | — | $17 – $23 |
| 14 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $90 | $90 | $70 | 77% | — | $21 – $160 |
| 15 | Aiken Regional Medical Centers North Augusta, SC fee schedule · both | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 16 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · both | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 17 | AnMed Health Anderson, SC facility · fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 18 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 19 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 20 | AnMed Piedmont Piedmont, SC facility · fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 21 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 22 | Appalachian Regional Healthcare, Inc. Whitesburg, KY percent of total billed charges · outpatientfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 23 | Appalachian Regional Healthcare, Inc. Middlesboro, KY percent of total billed charges · outpatientfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 24 | Aurora Sinai Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 25 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $32 | $35 | $6 | 17% | — | $32 – $46 |
← Payers reporting CPT 90700 · Snapshot 20261111T120946Z-9134e7f7