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
$80
Median
$57
High
$6.6k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
1484 hospitals; the 90th percentile is 4.5× 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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2,267 hospital rates
iThe hospitals that file a UnitedHealthcare 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 Hospitals East Communities Washington, MO professional · fee schedule · outpatient | 2 | $27 | $28 | $6 | 22% | 94–103 | $22 – $34 |
| 2 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 5 | $26 | $27 | $5 | 20% | 82–100 | $22 – $34 |
| 3 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 2 | $38 | $38 | — | — | 76 | $38 – $38 |
| 4 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | — | — | 44 | $47 – $47 |
| 5 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 2 | $30 | $30 | $4 | 14% | 26 | $26 – $34 |
| 6 | SONORA COMMUNITY HOSPITAL Sonora, CA percent of total billed charges · outpatientfrom % of charges | 4 | $48 | $70 | $45 | 63% | 20–200 | $20 – $155 |
| 7 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 3 | $50 | $54 | $9 | 18% | 18–36 | $45 – $67 |
| 8 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | — | — | 14 | $47 – $47 |
| 9 | DIGNITY HEALTH Folsom, CA fee schedule · outpatient | 5 | $58 | $49 | $13 | 28% | 4–40 | $32 – $62 |
| 10 | Pagosa Springs Medical Center Springs, CO percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | $39 | 100% | 4–40 | $0 – $80 |
| 11 | Duke University Hospital Durham, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $83 | $83 | $46 | 55% | 3–30 | $37 – $129 |
| 12 | Duke University Hospital Raleigh, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $83 | $83 | $46 | 55% | 3–30 | $37 – $129 |
| 13 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | $18 | 49% | 2–20 | $19 – $55 |
| 14 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 2 | $38 | $38 | — | — | 2–20 | $38 – $38 |
| 15 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · both | 2 | $38 | $38 | — | — | 2–20 | $38 – $38 |
| 16 | Mon Health Medical Center Morgantown, WV percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $76 | $9 | 12% | 2–20 | $64 – $88 |
| 17 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 3 | $50 | $45 | $8 | 17% | 2–20 | $34 – $51 |
| 18 | Preston Memorial Hospital Kingwood, WV percent of total billed charges · outpatientfrom % of charges | 2 | $69 | $69 | $14 | 20% | 2–20 | $54 – $84 |
| 19 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · outpatient | 1 | $57 | $57 | — | — | 2–20 | $57 – $57 |
| 20 | RAPIDES REGIONAL MEDICAL CENTER ALEXANDRIA, LA percent of total billed charges · outpatientfrom % of charges | 4 | $56 | $80 | $68 | 85% | 2–20 | $21 – $186 |
| 21 | The Children's Hospital of Alabama Birmingham, AL facility · percent of total billed charges · bothfrom % of charges | 1 | $49 | $49 | — | — | 2–20 | $49 – $49 |
| 22 | The Children's Hospital of Alabama Birmingham, AL facility · percent of total billed charges · bothfrom % of charges | 1 | $49 | $49 | — | — | 2–20 | $49 – $49 |
| 23 | Arkansas Childrens Hospital Little Rock, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $92 | $92 | — | — | 1–10 | $92 – $92 |
| 24 | Arkansas Childrens Northwest Springdale, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | 1–10 | $87 – $87 |
| 25 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $294 | $294 | — | — | 1–10 | $294 – $294 |
← Payers reporting CPT 90700 · Snapshot 20261112T124536Z-e251e855