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
PR Vaccine Polio (Ipv) Subcutaneous/Im
Low
$0
Average
$222
Median
$75
High
$8.8k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
762 hospitals; the 90th percentile is 11.8× 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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1,068 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 12 | $75 | $77 | $4 | 5% | 113–140 | $73 – $83 |
| 2 | Barnes Jewish Hospital St. Louis, MO fee schedule · both | 2 | $1.3k | $1.3k | $56 | 4% | 29–65 | $1.2k – $1.4k |
| 3 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $56 | $56 | — | — | 27 | $56 – $56 |
| 4 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 8 | $38 | $38 | $2 | 5% | 20–29 | $36 – $42 |
| 5 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 6 | $314 | $327 | $26 | 8% | 16–25 | $314 – $376 |
| 6 | Mayo Clinic Health System Owatonna 55060-5503 professional · percent of total billed charges · outpatientfrom % of charges | 8 | $38 | $38 | $2 | 5% | 14–23 | $36 – $42 |
| 7 | NYU Langone Brooklyn, NY percent of total billed charges · outpatientfrom % of charges | 50 | $205 | $202 | $10 | 5% | 11 | $164 – $205 |
| 8 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 2 | $45 | $44 | $1 | 3% | 8–80 | $41 – $45 |
| 9 | Eisenhower Medical Center Rancho Mirage, CA fee schedule · inpatient | 14 | $92 | $92 | — | — | 4–40 | $92 – $92 |
| 10 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 11 | $40 | $40 | $7 | 19% | 3–30 | $24 – $51 |
| 11 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 8 | $40 | $39 | $10 | 25% | 3–30 | $18 – $50 |
| 12 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 2 | $49 | $48 | $1 | 2% | 3–30 | $46 – $49 |
| 13 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · outpatient | 3 | $46 | $42 | $8 | 19% | 3–30 | $25 – $46 |
| 14 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $67 | $67 | — | — | 3–30 | $67 – $67 |
| 15 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $40 | $40 | $24 | 60% | 2–20 | $16 – $63 |
| 16 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 4 | $41 | $39 | $12 | 30% | 2–20 | $13 – $51 |
| 17 | Mayo Clinic Health System Waseca 56093-2811 facility · percent of total billed charges · bothfrom % of charges | 8 | $40 | $38 | $10 | 27% | 2–20 | $17 – $50 |
| 18 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 3 | $51 | $51 | — | — | 2–20 | $51 – $51 |
| 19 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $67 | $67 | — | — | 2–20 | $67 – $67 |
| 20 | The Presbyterian Hospital Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $32 | $32 | — | — | 2–20 | $32 – $32 |
| 21 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $60 | — | — | 1–10 | $60 – $60 |
| 22 | EATON RAPIDS MEDICAL CENTER Eaton Rapids, MI percent of total billed charges · outpatientfrom % of charges | 3 | $48 | $56 | $21 | 38% | 1–10 | $39 – $98 |
| 23 | MVHS, Inc. Utica, NY fee schedule · both | 1 | $47 | $47 | — | — | 1–10 | $47 – $47 |
| 24 | Mayo Clinic Health System Saint James 56081-5550 facility · percent of total billed charges · bothfrom % of charges | 6 | $40 | $40 | $8 | 19% | 1–10 | $22 – $50 |
| 25 | Mayo Clinic Health System Osseo, WI professional · fee schedule · outpatient | 1 | $42 | $42 | — | — | 1–10 | $42 – $42 |
← Payers reporting CPT 90713 · Snapshot 20261111T120946Z-9134e7f7