Tetanus and diphtheria vaccine, no preservative, intramuscular

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

TETANUS-DEPHTHERIA TOXOIDS (ADULT) 5-2 LF/0.5ML SUSP 0.5 ML SYRINGE

Payers reporting CPT 90714

Payer pricing summary

Low

Average

$232

Median

$70

High

$2.9k

Payer rate distribution

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#
1	Medicare professional · fee schedule · outpatient · +16 other terms	17	$38	$37	$5	14%	70–79	$16 – $39
2	Cigna fee schedule · outpatient · +29 other terms	401	$68	$92	$74	81%	16–160	$0 – $561
3	Blue Cross Blue Shield fee schedule · outpatient · +33 other terms	329	$49	$55	$38	69%	10–100	$0 – $302
4	Ambetter fee schedule · both · +19 other terms	20	$56	$67	$38	57%	5–50	$0 – $143
5	UnitedHealthcare fee schedule · outpatient · +36 other terms	531	$64	$66	$43	65%	3–30	$0 – $614
6	Medica fee schedule · outpatient · +19 other terms	69	$102	$82	$47	57%	2–20	$16 – $187
7	Caresource fee schedule · outpatient · +18 other terms	66	$43	$80	$66	82%	2–20	$1 – $189
8	Kaiser fee schedule · outpatient · +20 other terms	29	$97	$92	$70	76%	2–20	$1 – $378
9	Bcbs Ar percent of total billed charges · bothfrom % of charges	1	$41	$41	—	—	2–20	$41 – $41
10	Aetna fee schedule · outpatient · +31 other terms	193	$47	$110	$385	351%	1–10	$0 – $8.4k
11	Anthem fee schedule · outpatient · +25 other terms	129	$48	$55	$40	72%	1–10	$2 – $540
12	WellCare professional · fee schedule · outpatient · +21 other terms	26	$38	$36	$4	12%	1–10	$22 – $46
13	Humana fee schedule · outpatient · +27 other terms	208	$37	$121	$519	428%	—	$1 – $8.3k
14	MultiPlan fee schedule · outpatient · +21 other terms	90	$122	$147	$194	132%	—	$1 – $1.2k
15	Molina fee schedule · outpatient · +31 other terms	81	$38	$50	$50	100%	—	$1 – $620
16	Tricare facility · fee schedule · outpatient · +16 other terms	78	$36	$31	$35	111%	—	$0 – $226
17	Highmark facility · fee schedule · outpatient · +18 other terms	59	$38	$94	$75	80%	—	$11 – $328
18	Amerihealth Caritas facility · fee schedule · outpatient · +19 other terms	51	$28	$27	$18	67%	—	$10 – $74
19	Regence facility · fee schedule · both · +16 other terms	35	$42	$56	$31	56%	—	$10 – $239
20	First Health fee schedule · outpatient · +19 other terms	32	$105	$105	$70	67%	—	$0 – $366
21	Premera facility · fee schedule · both · +13 other terms	32	$41	$55	$29	52%	—	$16 – $149
22	Wellmark facility · fee schedule · both · +22 other terms	32	$41	$51	$27	52%	—	$15 – $149
23	Carefirst facility · fee schedule · both · +14 other terms	31	$42	$55	$28	51%	—	$33 – $149
24	Excellus facility · fee schedule · both · +14 other terms	31	$42	$52	$26	49%	—	$33 – $149
25	Medicaid facility · fee schedule · outpatient · +16 other terms	27	$24	$26	$13	49%	—	$10 – $70

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